经皮扩张气管切开术在重症脑血管意外患者抢救中的应用价值

Abstract
Figure/Table
References (16)
Related Citation (6)

Download: PDF (0 KB) HTML (45 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore the application value of percutaneous dilational tracheostomy（PDT）on the rescue of patientswith severe cerebrovascular accident.Methods Patientswith severe cerebrovascular accident treated in our hospital from June 2013 to December 2015 were selected as the research object.According to the way of tracheotomy，they were divided into percutaneous dilational tracheostomy（PDT group，50 cases）and conventional open tracheotomy group（OT group，55 cases）.The common conditions，NIHSS score before and after treatment，blood gas and biochemical indicators and the postoperative complications in the two groups were compared.Resu lts The operation time and healing time of PDT group were shorter than those of OT group，the size of incision was smaller than that of OT group，and the amount of intraoperative bleedingwas less than that of OT group，with statistical difference（P＜0.01）.There was no significant difference in NIHSS scores between the two groups before treatment（P＞0.05）.While after the rescue，the NIHSS scores of the two groupswere lower than those before treatment（P＜0.01），and the PDT group decreasedmore significantly（P＜0.01）.After rescue，the levels of SpO2and pH of the two groups were increased，and the levels of PCO2，lactate，ALT，BUN and Scr were all decreased，which weremore obvious in PDT group（P＜0.05）.The incidence rate of postoperative bleeding，subcutaneous emphysema in PDT group was significantly lower than those in OT group（P＜0.05）.But therewas no significant difference in the incidence rate of incision infection，tube prolapse and esophageal injury of the two groups（P＞0.05）.Conclusion PDT can significantly reduce the incidence of complications of tracheotomy，and has good clinical value.

Key words： Percutaneous dilational tracheotomy Severe cerebrovascular accident Rescue

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIBao-jia
	MOQuan
	SHIGang-ji
	LIANGCai-gan
	LIN Zi-tong
	TAN Da-an

Cite this article:

LIBao-jia,MOQuan,SHIGang-ji, et al. Study on the app lication value of percutaneous dilational tracheostom y on the rescue of patientsw ith severe cerebrovascular accident[J]. 中国当代医药, 2016, 23(21): 50-53.

URL:

http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I21/50

［4］	王平平，高颖，刘璐，等.NIHSS绝对值变化与NIHSS变化率对脑梗死患者残疾预测能力的比较研究［J］.中风与神经疾病杂志，2011，28（2）：156-158.
［5］	王冬梅，唐文，谢晶.重型颅脑损伤患者气管切开术后肺部感染的相关因素分析［J］.中华医院感染学杂志，2015，26（17）：4020-4022.
［1］	喻文，罗红敏.比较早期及晚期或未行气管切开术对机械通气危重患者病死率和肺炎的影响：一项回顾性Meta分析［J］.中华危重病急救医学，2015，23（10）：861-863.
［2］	王婷，张杰，王娟，等.气管插管或气管切开后气管狭窄的内镜诊疗［J］.中华结核和呼吸杂志，2015，38（8）：627-629.
［3］	廖云杰，柳茵，李万猛，等.老年性短暂性脑缺血发作患者中脑微出血发生与分布的相关危险因素分析［J］.磁共振成像，2015，6（12）：910-916.
［6］	Weissbrod PA，Merati AL.Is percutaneous dilational tracheotomy equivalent to traditional open surgical tracheotomy with regard to perioperative and postoperative complications［J］.Laryngoscope，2012，122（7）：1423-1424.
［7］	Foroulis CN，Nana C，Kleontas A，et al.Repair of post-intubation tracheoesophageal fistulae through the left pre-sternocleidomastoid approach：a recentcase seriesof13 patients［J］. JThorac Dis，2015，7（4）：20-26.
［8］	Ozdemirkan A，Ersoy Z，Zeyneloglu P，et al.Percutaneous dilational tracheotomy in solid-organ transplant recipients［J］. Exp Clin Transplant，2015，13（6）：48-51.
［9］	Pirat A，Candan S，Unlukaplan A，et al.Percutaneous dilational tracheotomy for airway management in a newborn with pierre-robin syndrome and a glossopharyngeal web［J］. Respir Care，2012，57（4）：627-630.
［10］	李勋，赵峰，王俊，等.单步经皮旋转气管切开术在呼吸衰竭患者抢救中的应用观察［J］.山东医药，2015，40（39）：75-76.
［11］	Nowak A，Langebach R，Klemm E，et al.Percutaneous dilational tracheostomy（PDT）and prevention of blood aspiration with superimposed high-frequency jet ventilation（SHFJV）using the tracheotomy-endoscope（TED）：results of numerical and experimental simulations［J］.Biomed Tech（Berl），2012，57（2）：107-111.
［12］	刘宝国.高血压脑出血外科治疗综述［J］.现代仪器与医疗，2015，21（3）：16-17.
［13］	杜秀玉，殷尚炯，刘洪泉，等.改良微创经皮气管切开术在神经外科肥胖重症患者中的应用［J］.临床耳鼻咽喉头颈外科杂志，2015，36（14）：1302-1303.
［14］	张雪锋，胡海敏，殷红，等.新型经皮扩张气管切开术在重型颅脑损伤患者中的应用研究［J］.中华急诊医学杂志，2015，24（9）：1040-1042.
［15］	朱翠香，彭玲玲，张冉令，等.一次性硬膜外麻醉导管气管切开插管留置大鼠模型的建立［J］.中华实验外科杂志，2015，32（10）：2480-2484.
［16］	赵磊，孙昀，杨进，等.经皮微创气管切开术在呼吸内科及ICU中的应用研究［J］.安徽医科大学学报，2015，26（4）：526-529.