经皮扩张与传统气管切开术在气管切开患者中的应用效果对比

Comparasion of application effect of percutaneous dilational tracheostomy and surgical tracheostomy on patients with tracheotomy

目的评价微创经皮扩张气管切开术（PDT）在ICU危重症患者中的应用价值。方法选取2005年5月~2014年8月行气管切开的患者384例,其中176例行PDT术,208例施行传统的开放式气管切开术（ST）,对比两组的手术时间、切口长度、术中出血量、切口愈合时间、瘢痕面积、围术期及后期并发症发生率、机械通气时间、住院天数、死亡率。结果 PDT组的手术时间、愈合时间均短于对照组（P〈0.01,P〈0.05）,切口长度短于ST组,术中出血量少于ST组,瘢痕面积小于对照组（P〈0.01）,两组的围术期、后期部分并发症发生率差异有统计学意义（P〈0.05）,两组的机械通气时间、住院天数、死亡率差异无统计学意义（P〉0.05）。结论 PDT是一种简单微创的外科手术,适合在ICU开展。

Objective To evaluate the application value of percutaneous dilational tracheostomy for critically ill patients in ICU. Methods 384 patients with tracheostomy were selected From May 2005 to August 2014,176 cases were given PDT operation,while 208 cases were given ST.Operation time,incision length,intraoperative blood loss,incision healing time,scar area,the incidence rate of perioperative and late complication,mechanical ventilation time,hospitalization day,the mortality in the two groups were compared. Results In the PDT group,operation time,incision healing time was shorter than that in the ST group（P〈0.01,P〈0.05）,incision length was shorter than that in the ST group,intraoperative blood loss were fewer than those in the ST group,scar area was smaller than that in the ST group（P〈0.01）;there was no statistical difference of incidence rate of partial perioperative and late complication in the two groups（P〈0.05）,there was no statistical difference of mechanical ventilation time after tracheostomy,hospitalization day and the mortality in the two groups（P〉0.05）. Conclusion PDT is a simple and minimally invasive surgery and it is suitable in ICU.