实时超声引导下经皮扩张气管切开术在神经重症患者中临床应用.docVIP

实时超声引导下经皮扩张气管切开术在神经重症患者中临床应用 　　[摘要]目的 探讨实时超声引导下经皮扩张气管切开术（US-PDT）在神经重症患者中的临床应用价值。方法 选取2012年6月～2017年2月于我院住院治疗的60例神经重症患者，随机分为对照组和观察组，各30例。对照组行传统气管切开术，观察组采用US-PDT治疗，比较两组的手术效果及并发症情况。结果 观察组的手术时间、切口愈合时间短于对照组，术中出血量少于对照组，差异有统计学意义（P0.05）。两组的术中低氧血症、术后局部皮下气肿、气管狭窄、局部感染等并发症发生率及死亡率比较，差异无统计学意义（P0.05）。观察组的术后出血事件及纵膈感染发生率低于对照组，差异有统计学意义（P0.05）。结论 US-PDT是临床行之有效的气管切开术，创伤更小，并发症发生率低，值得推广。 　　[关键词]超声引导下经皮扩张气管切开术；神经重症；并发症；出血事件 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721（2017）09（b）-0039-03 　　Clinical application of real-time ultrasound guided percutaneous dilatational tracheotomy in patients with severe neurological disorders 　　ZHOU Jian-qing SONG Jian-guo JIANG Ming-yuan 　　People′s Hospital of Lianhua County of Pingxiang City in Jiangxi Province，Lianhua 337100，China 　　[Abstract]Objective To explore the clinical application value of real-time ultrasound guided percutaneous dilatational tracheotomy （US-PDT） in patients with severe neurological disorders.Methods From June 2012 to February 2017，60 critical neurological inpatients in our hospital were selected and randomly divided into the control group and the observation group，30 cases in each group.The control group was treated with traditional tracheotomy，and the observation group was treated with real-time US-PDT.The surgical effect and complications between the two groups were compared.Results The operation time and incision healing time of the observation group was shorter than that of the control group，and the amount of bleeding during operation of the observation group was less than that of the control group，with significant difference （P0.05）.The incidence of complications including intraoperative hypoxemia，postoperative subcutaneous emphysema in local，tracheal stenosis，and local infection，and mortality were not displayed statistical differences （P0.05）.In the observation group，the occurrence of postoperative hemorrhage event and the incidence of mediastinal infection were lower compared with those in the control group （P0.05）.Co