目的 探讨紧急条件下采用经皮扩张气管切开术的安全性及有效性.方法 分析我科近两年来在紧急条件下采用经皮扩张气管切开术(PDT)方式建立的人工气道共17例,并与同期行开放性气管切开术(OT)的36例危重患者比较.结果 53例患者人工气道均成功建立,未发生操作相关严重并发症.其中PDT在操作时间、出血量、缺氧时间等方面较OT明显减少(P<0.01),1例患者发生气管狭窄,但与OT比较,差异无统计学意义(P＞0.05).结论紧急条件下经皮扩张气管切开术是较好的建立人工气道的方式,但需要严格把握适应症.%Objective To study the establishment of artificial airway with PDT in emergent condition. Methods 17 critical patients who established artificial airway with PDT in difficult condition were enrolled, and compared with the patients with OT. Results The artificial airway was all established successful. The operation time was significantly shortened [ ( 7. 99 ± 2. 17 )minutes vs. ( 26. 53 ± 4. 24 )minutes ], blood loss was significantly decreased [ ( 4. 35 ±1. 72 )ml vs. ( 17. 15 ±3. 67 )ml], lacking oxygen time was significantly shorter [ ( 13. 2 ±2. 2 )seconds vs. ( 33. 1 ±5. 5 ) seconds ] in PDT compared with OT ( all P ＜0. 01 ). And a case with tracheal stenosis was in PDT. Conclusion PDT is a good method to establish artificial airway in emergent condition, but within the scope of the indications.
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