微创医学

目的研究气管穿刺导入气管套管术在危重患者抢救中的疗效。方法将130例危重症患者随机分为观察组72例和对照组58例,观察组采取经皮气管造口一次性用具包行气管穿刺导入气管套管术,对照组行传统的开放性气管切开术的方案行气管切开后行呼吸机辅助呼吸。比较两组手术时长、手术出血量、气管切开伤口愈合时间、并发症发生等情况。结果与对照组比较,观察组所耗费的手术时间明显缩短,手术出血量明显减少,伤口切开所需愈合时间明显缩短,观察组切口出血、切口感染、皮下气肿、气管套管异位、脱管以及气胸等并发症发生率均显著低于对照组,其总并发症发生率分别为26.47%(18/68)和65.52%(38/58),两组比较差异有统计学意义(P<0.05)。结论通过气管穿刺导入气管套管术,手术时间短、创伤小、并发症少且能普遍满足于对急诊危重症患者的快速救治。

Objective To study treatment efficacy of early percutaneous tracheal puncture followed by trachea cannula in prehospital emergency treatment for respiratory distress. Method From 2003 to 2010, 130 cases of respiratory distress were randomly divided into the observation group (72 cases)and the control group (58 cases). The observation group was given early percutaneous tracheal puncture followed by trachea cannula using the Australian company′s more percutaneous tracheostomy disposable appliance line package, and the control group was performed traditional open tracheotomy followed by assisted breathing with ventilator. The operation time,surgical blood loss,tracheotomy,wound healing time,and complications were compared. Results The operating time,intraoperative blood loss,the wound healing time of the observation group were significantly shortened than those of the observation group. The rates of incision bleeding,wound infection,subcutaneous emphysema,trachea cannula migration,and the incidence of complications such as pneumothorax of the observation group were significantly lower than those of the control group. The total complication rate of two groups were 26. 47% (18 /68)and 65. 52% (38 /58),respectively(P < 0. 05). Conclusion Early percutaneous tracheal puncture followed by trachea cannula in prehospital emergency treatment for respiratory distress has the advantages of short operation time,small trauma and few complications,and it can meet the emergency requirement.