导丝扩张钳气管切开术在急诊困难气道患者治疗中的应用

摘要

目的 研究导丝扩张钳气管切开术(PDT)应用于急诊困难气道患者的可行性.方法 呼吸循环不稳定合并困难气道的急诊患者37例,采用Portex法行导丝扩张钳气管切开术建立确定性人工气道.结果 手术成功者35例(94.6%),失败者2例(5.4%).操作时间3～14 min,平均(10.3±3.4)min.成功者术中出血量4～15ml,均可自然止血.PDT患者术前心率和血氧指数(SpO2/FiO2)分别为(117.4±13.7)次/min、(246.2±65.8),术中分别为(120.6±9.9)次/min、(258.3±71.2),术后分别为(97.5±11.2)次/min、(377.4±74.9).SpO2/FiO2明显改善(t=8.679,P＜0.01),心率较术前减慢(t=4.649,P＜0.01).结论 导丝扩张钳气管切开术是急诊困难气道患者建立确定性人工气道的有效方法.%Objective To observe the application of percutaneous dilafional tracheostomy (PDT)in emergency patients with difficult airway. Methods The 37 cases in emergency with breathing-cycling unstable combination with difficult airway were treated with certainty artificial airway through PDT by Portex method. Results The operation success were 35 cases(94.6%), failure were 2 cases(5.4%) and the SpO2/FiO2 was significantly improved after PDT(t = 8. 679, P ＜ 0.01). Conclusion PDT is an effective method of creating certainty artificial airway in emergency with difficult airway.