经皮扩张气管切开术在口腔颌面外科麻醉中的应用

摘要

Objective To investigate the effect of preoperative percutaneous dilatational trache-otomy (PDT)in oral and maxillofacial surgery anesthesia versus traditional surgical tracheotomy (ST).Methods General data,vital signs,operation time,anesthetics,the amount of bleeding and complications during the procedure were analyzed after reviewing the clinical data of 124 cases under-going radical correction of oral and maxillofacial tumor plus flap transferring and repairing and trache-otomy during May 2013 to May 201 5.Results A total of 124 cases were divided into two groups:PDT group (group P,n =41)and ST group (group S,n =83).There was no significant difference of general data between the two groups.The incision length and operation time were significantly shorter and the amount of bleeding was remarkably lower in group P than those in group S (P <0.05),while the incidence of complications was not significantly different between the two groups.Conclusion PDT has more advantages over traditional ST and is a better airway approach in oral and maxillofacial surgery.%目的：探讨术前经皮扩张气管切开术(percutaneous dilatational tracheotomy,PDT)在口腔颌面外科手术麻醉中的临床应用价值,并与同期传统外科气管切开术(surgical tracheotomy, ST)进行比较。方法收集2013年5月至2015年5月,在我院口腔颌面外科行肿瘤根治伴皮瓣转移修复并且做气管切开术的124例患者资料,包括患者的一般资料、麻醉用药、气管切开时的生命体征、手术时间、出血量、并发症发生情况等。结果124例患者中41例行 PDT(P 组),83例行 ST(S组),两组患者一般资料差异无统计学意义。P 组切口长度和手术时间均明显短于 S 组(P <0.05),术中出血量明显少于 S 组(P <0.05)。两组并发症发生率差异无统计学意义。结论与 ST 相比, PDT 具有更多优点,更加适合于口腔颌面外科手术的气道管理。