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目的探讨经皮扩张气管切开术在ICU危重患者中的临床应用效果。方法选择2016年2月—2017年2月收治的行气管切开术的ICU危重患者88例,随机分为观察组和对照组各44例。观察组采用经皮扩张气管切开术,对照组采用传统气管切开术。观察两组手术时间、术前插管时间、术后ICU滞留时间、28 d病死率和并发症发生情况。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组手术时间、术前插管时间、术后ICU滞留时间[(8.65±4.32)、(6.32±2.94)、(10.62±4.61)min]均低于对照组[(23.41±9.87)、(9.24±3.78)、(16.72±5.73)min],比较差异有统计学意义(均P<0.05)。观察组28 d病死率(29.50%)低于对照组(54.50%),观察组并发症发生率(11.36%)低于对照组(65.90%),比较差异有统计学意义(均P<0.05)。结论经皮扩张气管切开术治疗ICU危重患者具有创伤小、手术时间短、并发症少等优点,可以在临床上广泛使用。
Objective To investigate the clinical effect of percutaneous dilation and tracheostomy in critically ill patients with ICU. Methods 88 critically ill patients with ICU underwent tracheotomy from February 2016 to February 2017 were randomly divided into observation group (44 cases) and control group (44 cases). The observation group used percutaneous dilation tracheotomy, the control group by tracheotomy. The operation time, preoperative intubation time, postoperative ICU residence time, 28-day mortality and complications were observed. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The operation time, preoperative intubation time and ICU retention time in the observation group were significantly lower than those in the control group ([(8.65 ± 4.32), (6.32 ± 2.94), (10.62 ± 4.61) min [(23.41 ± 9.87), 9.24 ± 3.78), (16.72 ± 5.73) min, respectively. The difference was statistically significant (all P <0.05). The 28-day mortality rate (29.50%) in the observation group was lower than that in the control group (54.50%). The incidence of complications in the observation group (11.36%) was lower than that in the control group (65.90% . Conclusion Percutaneous dilation and tracheostomy for the treatment of critically ill patients in ICU has the advantages of less trauma, shorter operation time and fewer complications, which can be widely used clinically.