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目的:比较经皮穿刺气管切开术(PDT)与传统开放式气管切开术(OT)在手术操作和并发症上的差异,探讨其在危重患者紧急抢救中的应用价值。方法:30例急诊拟行气管切开术的患者,随机分为两组。OT组15例行传统气管切开术,PDT组15例行经皮穿刺气管切开术,记录并比较两组患者的手术时间、切口大小、术中出血量及术后并发症、心率、血压和氧饱和度的变化。结果:PDT组手术时间、切口大小、术中出血、术后并发症发生率均明显低于OT组,术后1 h心率和收缩压也明显低于OT组(P均<0.05),但两组术后1 h的平均动脉压和血氧饱和度之间差异无显著性(P>0.05)。结论:与传统气管切开术比较,经皮穿刺气管切开术具有手术时间短、切口小、出血量少、并发症少等优点,适合在紧急抢救中应用。
Objective: To compare the difference of surgical operation and complications between percutaneous tracheotomy (PDT) and traditional open tracheotomy (OT), and to explore its value in the emergency rescue of critically ill patients. Methods: Thirty patients with acute tracheotomy were randomly divided into two groups. Fifteen patients in the OT group underwent conventional tracheotomy and 15 patients in the PDT group underwent percutaneous tracheotomy. The operation time, incision size, intraoperative blood loss, postoperative complications, heart rate, blood pressure And oxygen saturation changes. Results: The operation time, incision size, intraoperative bleeding and the incidence of postoperative complications in PDT group were significantly lower than those in OT group. The heart rate and systolic pressure at 1 hour after PDT were also significantly lower than those in OT group (P <0.05) The mean arterial pressure and oxygen saturation at 1 h after operation were not significantly different (P> 0.05). Conclusion: Compared with traditional tracheotomy, percutaneous tracheostomy has the advantages of short operation time, small incision, less bleeding, less complications and is suitable for emergency rescue.