120例经皮气管旋切术患者的临床疗效分析

摘要

目的 分析经皮气管旋切术在ICU的应用效果,为手术提供参考.方法 选取2014年1月至2016年1月在本院ICU进行气管切开患者240例为观察对象,根据气管切开方法分为对照组与观察组各120例.对照组实施传统气管切开术进行治疗,观察组实施经皮气管旋切术进行治疗,观察两组患者手术时间与术后并发症发生情况,评估手术效果.结果 观察组患者出血量、手术时间与切口长度显著低于对照组.观察组患者术后2.50％出现切口溢痰、0.00％出现心跳骤停、12.50％出现皮下气肿、5.00％出现术后出血、5.83％出现气管狭窄,均显著低于对照组的16.67％、3.33％、25.83％、15.00％、16.67％,两组比较差异有统计学意义(P＜0.05);观察组疗效优者为81.67％,优良率为91.67％,均显著高于对照组的67.50％、80.83％,两组比较差异有统计学意义(P＜0.05).观察组患者77.50％手术难度为Ⅰ显著高于对照组的65.00％,0.00％手术难度为Ⅲ显著低于对照组的3.33％ (P＜0.05).结论 经皮气管旋切术操作简便,切口小,并发症发生率低,安全性高,效果显著.%Objective To explore the clinical effect of percutaneous tracheal atherectomy in ICU.Methods 240 cases of tracheotomy in ICU of our hospital from January 2014 to January 2016 were selected as the object of observation,and divided into control group and observation group according to the methods of tracheotomy with 120 cases in each group.Control group was treated by traditional tracheotomy,while observation group was treated by percutaneous tracheal atherectomy.Observed operation time and postoperative complications of two groups.Results The blood loss,operation time,and length of incision of observation group were significantly lower than those of control group (P＜0.05).The rate of postoperative excessive phlegm from incision,cardiac arrest,pneumoderm,bleeding,tracheostenosis of observation group were significantly lower than those of control group (2.50％ vs.16.67％,0.00％ vs.3.33％,12.50％ vs.25.83％,5.00％ vs.15.00％,5.83％ vs.16.67％),with statistically significant differences (P＜0.05).The excellent rate,excellent and good rate of observation group were significantly higher than those of control group (81.67％ vs.67.50％,91.67％ vs.80.83％),with statistically significant differences (P＜0.05).The rate of degree Ⅰ surgical difficulty of observation group was significantly higher than that of control group (77.50％ vs.65.00％),the rate of degree Ⅲ surgical difficulty of observation group was significantly lower than that of control group (0.00％ vs.3.33％),with statistically significant differences (P＜0.05).Conclusion Percutaneous tracheal atherectomy has the advantages of convenient operation,small incision,lower incidence of complications,remarkable effect,high security.