摘要
目的:探讨牛角型经皮气管切开术在神经外科危重患者中的应用价值。方法:回顾性分析神经外科危重患者采用牛角型经皮气管切开术(GWCH组95例)和常规气管切开术(ST组83例)的切口大小、手术时间、术中出血量、切口愈合时间及并发症发生率。结果:GWCH组患者较ST组患者的切口少[(1.6±0.4)cm vs.(3.8±0.9)cm]、手术时间短[(4.4±2.8)min vs.(20.5±5.2)min]、术中出血量少[(4.5±0.8)m L vs.(8.5±4.5)m L]、切口愈合时间短[(3±0.5)d vs.(5±1.5)d],差异均具有统计学意义(P<0.01);GWCH组患者术后渗血发生率[2/95(2.1%)]较ST组[14/83(16.9%)]低(P<0.05),GWCH组患者切口渗痰发生率[1/95(1.1%)]较ST组[12/83(14.5%)]低(P<0.01),其余并发症发生率比较,差异均无统计学意义(P>0.05)。结论:牛角型经皮气管切开术具有切口小、手术时间短、术中出血少、愈合快及术后渗血和切口渗痰发生率低等特点,在神经外科危重患者中可广泛应用。
Objective To introduce the experience of applying horns percutaneous tracheostomy in critically ill neurosurgical patients. Methods The size of operative incision, operation time, amount of blood loss,incision healing time, and incidence of complications were analyzed retrospectively in 95 patients with GWCH and 83 with ST. Results There were smaller size of operation incision [（1.6 ± 0.4） cm vs.（3.8 ± 0.9） cm],shorter operation time [（4.4 ± 2.8） min vs.（20.5 ± 5.2） min], less blood loss [（4.5 ± 0.8） m L vs.（8.5 ±4.5） m L] and shorter incision healing time [（3 ± 0.5） d vs.（5 ± 1.5） d] in GWCH group than that in ST group and the difference was statistical significant（P〈0.01）. The incidence of incision blood leaking after operation was lower in GWCH group（2.1%） than that in ST group（16.9%） and the incidence of incision sputum leaking was lower in GWCH group（1.1%） than that in ST group（14.5%）, but no difference was found in terms of the incidence of other complications（P〈0.05）. Conclusions When compared with traditional ST,horns percutaneous tracheostomy is with smaller incisions, shorter operation time, less blood loss, faster healing and lower incision sputum leaking and is worthy of popularization in critically ill neurosurgical patients.
出处
《实用医学杂志》
CAS
北大核心
2016年第15期2452-2453,共2页
The Journal of Practical Medicine
基金
教育部留学回国人员科研启动基金项目(编号:082003)
上海市卫生和计划生育委员会科研基金面上项目(编号:201540266)
上海交通大学医工交叉研究基金项目(编号:YG2015MS25)
上海交通大学医学院附属第三人民医院自然科学研究基金项目(编号:syz2015-015)
