超声引导下经皮气管切开术对ICU患者血清C-反应蛋白、白细胞介素-8和肿瘤坏死因子-α的影响

Effects of ultrasound-guided percutaneous tracheotomy on the serum levels of C reactive protein,interleukin-8 and tumor necrosis factor-αof patients in ICU

目的评价超声引导下经皮气管切开术对ICU患者血清C-反应蛋白(CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的影响。方法选取2017年1月至2018年8月在ICU行气管切开术成年患者52例,按治疗方法分为对照组与观察组。无影像引导手术病例为对照组(n=27),超声实时引导经皮气管切开术组为观察组(n=25),比较2组术中术后指标、血清CRP、IL-8、TNF-α水平、并发症、满意率的差异。结果观察组患者手术时间及术中出血量显著低于对照组,差异有统计学意义(P<0.05)。观察组术中再次经口插管、术后气胸/纵膈气肿、伤口感染、渗血、溢痰等并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。干预后2组患者血清CRP、IL-8、TNF-α水平均降低,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组总满意率(96.00%)显著高于对照组(62.96%),差异有统计学意义(P<0.05)。结论超声引导下使用经皮气管切开术更安全,值得在ICU推广。

Objective To investigate the effects of ultrasound-guided percutaneous tracheotomy on the serum levels C reactive protein,interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)of patients in ICU.Methods A total of 52 adult patients who underwent tracheotomy in ICU of our hospital from January 2017 to August 2018 were enrolled in the study.According to the treatment method,who were divided into control group(n=27)and observation group(n=25).The patients in control group were treated by askiatic guided surgery,however,the patients in observation group were treated by ultrasound-guided percutaneous tracheotomy.The intraoperative and postoperative indexes,and serum levels of CRP,IL-8,TNF-α,incidence of complications and satisfaction rate were observed and compared between the two groups.Results The operative time and intraoperative bleeding volume in observation group were significantly lower than those in control group(P<0.05),and the incidence rates of complications including reintubation,postoperative pneumothorax/diaphragm emphysema,wound infection,blood seepage and sputum overflow in observation group were significantly lower than those in control group(P<0.05).The serum levels of CRP,IL-8,TNF-αin both groups were decreased after intervention,moreover,which in observation group were significantly lower than those in control group(P<0.05).In addition the total satisfaction rate in observation group was 96.00%,which was significantly higher than that(62.96%)in control group(P<0.05).Conclusion The ultrasound-guided percutaneous tracheotomy is safer and worth promoting in ICU.