单步扩张经皮气管切开应用于急危重症患者的临床评价

Clinical Evaluation of One-step Percutaneous Dilational Tracheostomy to Critical Patients

目的:比较单步扩张经皮气管切开术(one-step percutaneous dilational tracheostomy,PDT)与传统外科气管切开术(surgical tracheostomy,ST)手术情况及并发症的差异,探讨PDT的可行性和临床价值。方法:选取厦门大学附属第一医院2016年10月-2018年9月拟行气管切开患者124例,随机分为PDT组和ST组,对比两组手术时间、术中出血量、切口长度及术后并发症发生率。结果:PDT组平均手术时间、术中出血量、切口长度为(9.5±1.8)min、(5.7±1.3)ml、(1.3±0.2)cm,均少于ST组的(26.0±3.2)min、(19.0±2.1)ml、(3.8±0.5)cm,差异均有统计学意义(P<0.05)。PDT组围术期、近期并发症及总并发症发生率分别为3.17%、1.59%、4.76%,均低于ST组的26.22%、9.84%、36.06%,差异均有统计学意义(P<0.05)。结论:单步扩张经皮气管切开术操作简单、创伤少、并发症少,值得临床推广应用。

Objective:To explore the feasibility and value of single-step percutaneous tracheotomy(PDT)by comparing the differences of operation and complications between the PDT groups and the surgical tracheostomy(ST)group.Method:From October 2016 to September 2018,124 patients eligible to meet tracheotomy in First Affiliated Hospital of Xiamen University were recruited,and divided into PDT group and ST group randomly.The procedural operation time,bleeding volume,length of incision and the incidence of post-operative complication were analyzed.Result:In the PDT group,The procedural operation time,bleeding volume,length of incision were(9.5±1.8)min,(5.7±1.3)ml and(1.3±0.2)cm,less than(26.0±3.2)min,(19.0±2.1)ml and(3.8±0.5)cm in the ST group,and the differences were statistically significant(P<0.05).The incidence of perioperative complications,recent complications and total complications in the PDT group were 3.17%,1.59%and 4.76%,which were lower than 26.22%,9.84%,36.06%in the ST group,and the differences were statistically significant(P<0.05).Conclusion:0ne-step percutaneous dilational tracheostomy is worth using widely in clinic due to its more convenient,less trauma and less complications.