深静脉穿刺包联合床旁吸痰装置行经皮扩张气管切开术对危重患者气道管理的效果及安全性评价

Effect and safety evaluation of percutaneous dilational tracheostomy with deep venous puncture bag combined with bedside suctioning device for airway management in critically ill patients

目的评价采用深静脉穿刺包联合自行研发的吸痰装置实施经皮扩张气管切开术,对危重患者行气道管理的效果及安全性。方法回顾性我院重症医学科60例行气管切开患者的临床资料,其中试验组30例,对照组30例,比较两组的吸痰效果和安全性。结果与使用常规气管切开术具有相同的效果和安全性,但使用深静脉穿刺包其操作时间和手术费用却较前者降低,有统计学意义(P<0.01),而研发的吸痰装置吸痰时间(17.1±6.7)小于对照组(21.0±10.1),有统计学意义(P<0.01)。两种方法吸痰后对黏膜的损伤,差异有统计学意义(χ2=4.01,P<0.05)。两种方法吸痰效果比较,试验组患者痰鸣音减弱或消失率均明显高于对照组患者,差异具有统计学意义(P<0.05)。结论具有深静脉穿刺包联合微创化吸痰装置,较常规方法有同样的效果和安全性,但手术费用、操作时间、气道黏膜损伤却有显著降低,对于保证穿刺位置有很好的引导作用,增快了吸痰后的血氧恢复。

Objective To evaluate the efficacy and safety of percutaneous tracheostomy with deep venous puncture bag combined with sputum suction device developed by ourselves in critically ill patients. Methods the clinical data of 60 cases of tracheotomy in our severe medical department were retrospectively analyzed,including 30 cases in the experimental group and 30 cases in the control group,and the efficacy and safety of sputum aspiration were compared between the two groups. Results The result has the same effect and safety with the use of conventional tracheotomy,but the use of deep vein puncture bag for the operation time and operation cost is lower than the former,there was statistical significance( P< 0. 01),the research and development of sputum suction device time( 17. 1+ 6. 7) than the control group( 21 + 10. 1),there was statistical the significance( P < 0. 01). The damage to the mucosa of the two methods of sputum suction,the difference was statistically significant( χ2= 4. 01,P< 0. 05). A comparison of two methods of sputum suction effect,test group of patients with sputum stridor decreased or disappeared rate were significantly higher than in the control group,the difference was statistically significant( P<0. 05). Conclusion with deep vein puncture bag combined with minimally invasive suction device,has the same effect and safety compared with the conventional method,but the operation cost,operation time,airway mucosal injury was significantly reduced,to ensure the puncture position have a very good guide,increase the blood oxygen suction after recovery.