CAJ | 학술논문

目的：比较经皮扩张气管切开术（PD T ）与传统气管切开术（O T ）在建立人工气道过程中的临床应用效果。方法80例需气管切开患者分为PD T组与O T组，每组各40例。对比两种术式分别在有、无气管插管状态下的术中出血、低氧血症、窒息，气胸、纵隔气肿等并发症的发生率。结果在有气管插管状态下，PD T组出现术中出血、低氧血症、窒息，气胸、纵隔气肿等并发症发生4例，O T组术中出血、低氧血症、窒息，气胸、纵隔气肿等并发症发生3例，两组比较差异无统计学意义（P＞0．05）．在无气管插管状态下，PD T组术中出血、低氧血症、窒息，气胸、纵隔气肿等并发症共发生5例；O T组术中出血、低氧血症、窒息，气胸、纵隔气肿等并发症共发生11例，两组对比差异有统计学意义（ P＜0．01）。结论有气管插管状态下进行经皮扩张气管切开术相对于传统气管切开术在安全、有效建立人工气道过程中无明显优势；无气管插管状态下经皮扩张气管切开术相对于传统气管切开术在安全、有效建立人工气道过程中有明显优势。
목적：비교경피확장기관절개술（PD T ）여전통기관절개술（O T ）재건립인공기도과정중적림상응용효과。방법80례수기관절개환자분위PD T조여O T조，매조각40례。대비량충술식분별재유、무기관삽관상태하적술중출혈、저양혈증、질식，기흉、종격기종등병발증적발생솔。결과재유기관삽관상태하，PD T조출현술중출혈、저양혈증、질식，기흉、종격기종등병발증발생4례，O T조술중출혈、저양혈증、질식，기흉、종격기종등병발증발생3례，량조비교차이무통계학의의（P＞0．05）．재무기관삽관상태하，PD T조술중출혈、저양혈증、질식，기흉、종격기종등병발증공발생5례；O T조술중출혈、저양혈증、질식，기흉、종격기종등병발증공발생11례，량조대비차이유통계학의의（ P＜0．01）。결론유기관삽관상태하진행경피확장기관절개술상대우전통기관절개술재안전、유효건립인공기도과정중무명현우세；무기관삽관상태하경피확장기관절개술상대우전통기관절개술재안전、유효건립인공기도과정중유명현우세。
Objective To compare percutaneous dilational tracheostomy (PDT ) and traditional tracheotomy(OT) clinical application effect in the process of establishment of artificial airway .Methods 80 cases of tracheotomy patients were divided into PDT group and OT group ,40 cases in each group . Comparison of two operative methods in ,without intubation condition of intraoperative hemorrhage ,hypoxia , asphyxia ,the incidence of complications such as pneumothorax ,mediastinal emphysema .Results in the tracheal intubation condition ,PDT group ,intraoperative hemorrhage ,hypoxia ,asphyxia ,4 cases occurred pneumothorax ,mediastinal emphysema and other complications ,group OT intraoperative hemorrhage , hypoxia ,asphyxia ,3 cases occurred pneumothorax ,mediastinal emphysema and other complications ,the difference between the two groups was not statistically significant (P> 0 .05) .In the absence of tracheal intubation condition ,PDT group of intraoperative hemorrhage ,asphyxia ,hypoxemia ,pneumothorax , mediastinal emphysema and other complications occurred in 5 cases;group OT intraoperative hemorrhage , asphyxia ,hypoxemia ,pneumothorax ,mediastinal emphysema and other complications occurred in 11 cases , two contrast the difference is statistically significant (P<0 .01) .Conclusion tracheal intubation condition of percutaneous dilational tracheostomy compared to traditional tracheotomy in the security ,the effective establishment of no obvious advantage in the process of artificial airway ;endotracheal intubation conditions without percutaneous dilational tracheostomy relative to traditional tracheotomy in safe , effective establishment has obvious advantage in the process of artificial airway .