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1 对象和方法 1.1 研究对象:男74例,女32例,年龄55～92岁,平均64.8岁。原发疾病类型:脑出血及颅脑损伤74例,呼吸道烧伤9例,老年慢性支气管炎7例,喉癌7例,颌面部复合伤4例,其它伤5例。52例合并多脏器功能不全综合征,受累脏器为肺、胃肠、脑、周围循环系统和凝血系统。 1.2 手术指征:①下呼吸道梗塞:颅脑外伤、脑血管意外、呼吸道烧伤等患者,咳嗽反射消失,下呼吸道分泌物潴留,作气管切开术,通过气管套管便于吸除分泌物,减少呼吸道死腔,改善肺部气体交换。②颌面部、颈部外伤或头颈部大手术前作预防性气管切开术。③呼吸肌麻痹时作气管切开术应用呼吸
1 Subjects and methods 1.1 Study: 74 males and 32 females, aged 55 to 92 years, an average of 64.8 years old. Primary disease types: 74 cases of cerebral hemorrhage and head injury, respiratory burn in 9 cases, 7 cases of chronic bronchitis, laryngeal cancer in 7 cases, maxillofacial composite injury in 4 cases, other injuries in 5 cases. 52 cases with multiple organ dysfunction syndrome, the affected organs of lung, gastrointestinal, brain, peripheral circulatory system and coagulation system. 1.2 Surgical indications: ① lower respiratory tract infarction: craniocerebral trauma, cerebrovascular accident, respiratory burn and other patients, cough reflex disappeared, retention of lower respiratory secretions for tracheotomy, easy to remove secretions through the tracheal tube to reduce Respiratory dead space, improve lung gas exchange. ② maxillofacial, neck trauma or head and neck before major surgery for preventive tracheotomy. ③ Respiratory muscle paralysis for tracheostomy application of respiration