“⊥”形气管切口在气管切开术中的应用
The Application of “⊥” Trachea Incision in Tracheotomy
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摘要: 目的 探讨“⊥”形切口在气管切开术中的临床疗效及应用.方法 对昆明医科大学第一附属医院2014年3月至2015年12月共300例气管切开术前瞻性研究, 采用“⊥”形气管切口 (A组) 和“I”形气管切口 (B组) 行气管切开术, 统计“一次性顺利插入、气囊破裂、相关并发症”数据.结果 一次性顺利插入:A组144/150例 (96%) , B组90/150例 (60%) , P<0.01;气囊破裂:A组3/150例 (2%) , B组15/150例 (10%) , P<0.05;术后并发症 (术后出血、皮下气肿、气胸、喉气管狭窄) :A组10/150例 (6.7%) , B组25/150例 (16.7%) , P<0.05.结论 “⊥”形气管切口在气管切开术中, 操作简单安全, 并发症少, 值得推广应用.Abstract: Objective The study discusses the clinical efficacy, surgical technique and new technology application of “ ⊥ ” incision in tracheotomy. Me thods From March 2014 to December 2015, a total of 300 patients treated in the First Affiliated Hospital of Kunming Medical University with tracheotomy prospective were studied.The statistics of success rate of incision, balloon cuff rupture and complications of “ ⊥ ” form incision (group A) and“I”form incision (group B) during tracheotomy.Result In group A, 144 out of 150 cases (96%) were inserted successfully for the first try, while the first incision was successful in 90/150 cases of group B (60%) (P<0.01) . Balloon cuff rupture was found in 3/150 cases (2%) in group A and 15/150 cases (10%) in group B (P <0.05) . The postoperative complications (postoperative bleeding, subcutaneous emphysema, pneumothorax, laryngotracheal stenosis) were observed in 10/150 cases (6.7%) in group A and 25/150 cases (16.7%) in group B (P<0.05) .Conclusion The“⊥” tracheal incision is simple, safe and causes fewer complications. It is worthy of generalization and application.
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Key words:
- Tracheotomy /
- Trachea incision /
- Application
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[1]刘力新, 陈超杰, 罗醒政.呼吸气囊辅助下紧急经皮气管切开术在急性上呼吸道梗阻中的应用[J].中华急诊医学杂志, 2015, 24 (6) :669-670. [2] [2]MABRY R L, KHAROD CU.Awake cricothyrotomy:A novel approach to the surgical airway in the tactical setting[J].Wilderness Environ Med, 2017, 28:S61-68. [3]魏辉明, 王玲玲, 邱昌明, 等.超声引导环甲膜穿刺气道表麻对经鼻气管插管反应的影响[J].昆明医科大学学报, 2017, 38 (9) :105-108. [4] [4]HU R, LIU J X, JIANG H.Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation:A double-blinded randomized controlled trial[J].J Anesth, 2013, 27 (2) :211-217. [5]单可记, 王雨平, 杨肖蓉, 等.右美托咪定联合氯胺酮麻醉诱导困难气道插管[J].昆明医科大学学报, 2015, 36 (5) :108-111. [6]黄选兆, 汪吉宝, 孔维佳.实用耳鼻喉科头颈外科学[M].第2版.北京:人民卫生出版社, 2007:451-458. [7] [7]PAULINY M, CHRISTOVA E, MACKOVA J, et al.Percutaneous dilation tracheostomy versus surgical tracheostomy in critically ill patients[J].Bratisl Lek listy, 2012, 113 (7) :409-411. [8]张陇平, 左明武, 韩小芳.高血压脑出血术后早期气管切开对防止肺部感染的影响[J].中国微生态学杂志, 2017, 29 (07) :826-838. [9]姚建英, 杨燕, 蔡福良, 等.早期气管切开对重型颅脑损伤术后肺部感染的影响[J].实用临床医药杂志, 2018, 22 (05) :119-124. [10]徐建国, 陈新国, 潘娅静.不同气管切开术的应用对比研究[J].中华耳鼻咽喉头颈外科杂志, 2007, 42 (11) :869-870. [11]张云高, 何志刚, 刘健民, 等.横切口在气管切开术中的应用体会[J].临床军医杂志, 2012, 40 (2) :398-399. [12]傅启红, 王杰, 刘国旗, 等.弧形切口在气管切开术中插管的对比研究[J].四川医学, 2003, 24 (10) :396. [13]李光照.选择性横行低位气管切开术[J].山东大学耳鼻喉眼学报, 2008, 22 (1) :325-326. [14] [14]AKULIAN JA, YARMUS L, FELLER-KOPMAN D, et al.The role of cricothyrotomy, tracheostomy, and percutaneous tracheostomy in airway management[J].Anesthesiol Clin, 2015, 33 (2) :357-367. [15] [15]MICHELS G, BOVENSCHULTE H, VON BERGWELT-BAILDON M, et al.Complication after percutaneous dilation tracheostomy[J].Dtsch Med Wochenschr, 2011, 136 (21) :1121-1122. [16] [16]SANABRIA A.Which percutaneous tracheostomy method is better asystematic review[J].Respir Care, 2014, 59 (11) :1660-1670.
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