床旁超声引导下经皮扩张气管切开术在危重症老年患者中的应用

Clinical application of real-time ultrasound-guided percutaneous dilatational tracheostomy in critical elderly patients

目的探讨在老年危重症患者中应用床旁超声引导下经皮扩张气管切开术的安全性及疗效。方法回顾分析自2015年1月-2017年1月在海军总医院完成床旁超声引导下经皮扩张气管切开术的老年危重症患者病例共22例。收集患者手术前一般资料、气管环及气管环周围组织的超声影像，记录手术时间、术中出血量、最低氧饱和度及并发症发生情况。结果所有床旁实时超声引导下经皮扩张气管切开术的例患者均成功置人气管切开管，一针穿刺成功率达86．4％。术中出血量少，术后并发症低。结论床旁超声引导下经皮扩张气管切开术在老年危重症患者中安全可行。

Objective To evaluate the clinical efficacy and safety of real-time ultrasound-guided percutaneous dilatational tracheostomy（US-PDT） in critical elderly patients. Methods The data of 22 eases elderly patients in our hospital from January 2015 to January 2017 which Completed real-time US-PDT was studied retrospectively. Their general information before the operation, ultrasonic images of Trachea ring and surrounding tissues were summarized. The operation time, bleeding, intraoperative and postoperative complications were analyzed. Results All patients completed US-PDT successfully and the successful rate by first puncture in patients was 86.4%. The cases underwent US-PDT had shorter operation time, less bleeding, fewer complications. Conclusion The US-PDT can be used safely and effectively in critical elderly patients.