经皮气管切开术的技巧及临床应用分析

发布时间：2018-04-17 22:37

本文选题：气管切开术 + 技巧　；参考：《中国全科医学》2017年S2期

【摘要】：目的分析研究经皮气管切开术的技巧及临床应用效果。方法选择扬州市第一人民医院东区重症医学科2012年8月—2015年6月间接受经皮气管切开术治疗的82例患者作为研究对象,回顾性分析所有患者的临床资料,探讨经皮气管切开术的临床应用效果,总结其应用技巧。结果 82例患者全部完成气管切开导管置入,无1例转开放手术或终止手术,手术成功率为100%。手术时间为(8.5±3.5)min、术中出血量(5.4±3.4)ml、术后出血量为(5.3±0.5)ml。82例患者中1例术中出现颈部动脉性出血,予局部压迫缝扎止血后完成手术,发生概率1.22%;1例由于术中置管困难,予重新扩张皮下瘘道,调整置管方向后成功置入气管切开导管,发生概率1.22%;1例术后出现长时间(超过6个月)留置气管切开导管气管狭窄,发生概率1.22%。余无重大或致命性并发症发生。结论经皮气管切开术的临床应用效果满意,且可在极大程度上缩短手术时间,减少患者术中及术后出血量,手术安全性较高,同时并发症发生概率较低,可作为临床气管切开治疗的首选方法。
[Abstract]:Objective to study the technique and clinical effect of percutaneous tracheotomy.Methods Eighty-two patients treated with indirect percutaneous tracheotomy from August 2012 to June 2015 in the Department of Eastern intensive Medicine of the first people's Hospital of Yangzhou were selected as the study subjects. The clinical data of all the patients were analyzed retrospectively.To investigate the clinical effect of percutaneous tracheotomy and summarize its application skills.Results all 82 patients underwent tracheotomy and catheterization, none of them turned to open operation or terminated operation. The success rate of operation was 100%.The operative time was 8.5 卤3.5 min, the intraoperative bleeding volume was 5.4 卤3.4 ml, and the postoperative bleeding volume was 5.3 卤0.5)ml.82 in 1 case. The cervical artery hemorrhage occurred in 1 case after local compression and suture hemostasis. The probability was 1.22%, and 1 case was re-dilated subcutaneous fistula because of the difficulty of catheterization during the operation.After adjusting the direction of tracheotomy, the probability of tracheotomy was 1.22% and the probability of occurrence was 1.22% in 1 case with long time (more than 6 months) indwelling tracheotomy trachea stenosis after operation.No major or fatal complications occurred.Conclusion the clinical application of percutaneous tracheotomy is satisfactory, and it can greatly shorten the operation time, reduce the amount of blood loss during and after operation, have high safety, and lower the probability of complications.It can be used as the first choice in the treatment of tracheotomy.
【作者单位】：江苏省扬州市第一人民医院;
【分类号】：R653

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