CAJ | 학술논문

目的：探讨经皮扩张气管切开术在SICU危重患者中的临床应用效果。方法在外科重症监护病房(SICU)内，对82例有气管切开指征的患者采用经皮扩张气管切开术，总结其临床应用的效果及体会。结果在3～15min内完成了气管切开及气管套管的插入，其中2例插入困难患者经调整位置后插入，1例术后切口渗血，2例切口周围局部皮下气肿，1例诱发心律失常。术后26例因基础疾病不可逆转在拔除气管套管前死亡，32例病情好转尚未拔管回当地治疗后失访，余24例气管套管留置时间为12~112d，拔管后创口愈合时间3～5d，21例随访拔管后6个月～1年，其中1例出现气道息肉导致气管狭窄行手术治疗外，余均未出现并发症。结论经皮扩张气管切开术是一种安全、快捷、有效地建立长久人工气道的微创急救新技术，对危重患者的救治有重要应用价值，可在 ICU、SICU或其它相关科室推广应用。
목적：탐토경피확장기관절개술재SICU위중환자중적림상응용효과。방법재외과중증감호병방(SICU)내，대82례유기관절개지정적환자채용경피확장기관절개술，총결기림상응용적효과급체회。결과재3～15min내완성료기관절개급기관투관적삽입，기중2례삽입곤난환자경조정위치후삽입，1례술후절구삼혈，2례절구주위국부피하기종，1례유발심률실상。술후26례인기출질병불가역전재발제기관투관전사망，32례병정호전상미발관회당지치료후실방，여24례기관투관류치시간위12~112d，발관후창구유합시간3～5d，21례수방발관후6개월～1년，기중1례출현기도식육도치기관협착행수술치료외，여균미출현병발증。결론경피확장기관절개술시일충안전、쾌첩、유효지건립장구인공기도적미창급구신기술，대위중환자적구치유중요응용개치，가재 ICU、SICU혹기타상관과실추엄응용。
Objective To study the clinical application ef ect of percutaneous dilational tracheostomy for critical patients in SICU. Methods A retrospective analysis of 82 cases of PDT was performed to identify the clinical relevant outcomes in the Central Hospital of Xiangtan. ResultsThe PDT procedures were completed in 3-15minutes in al patients. In2cases with dif iculty of intubation,tracheotomy was succeeded after adjusting the position by bronchofiberscope.Smal amount of errhysis at the operative incision occurred in 1 case,and subcutaneous emphysema formed around the operative incision in 2 cases,The procedure elicited arrhythmias in1case.26patients died before the tracheal cannula was pul ed because of the underlying diseases. Loss of fol ow-up occurred in 32 cases that had returned to their home places.The retention time of the tracheal intubation was 12to112 days in the remaining 24patients. The healing time of the wound after the extubation was 3-5days.One of the patients appeared tracheal stenosis and underwent surgery,others weren't found any complication during the fol ow-up lasting half year to one year after the extubation in 21 patients.Conclusion The PDT is a safe,easy,and ef ective aid technique to establish artificial airway,it is useful in the treatment of critical patients.The PDT could be popularization and application in ICU,SICU or other relevant departments.