经皮气管切开与传统气管切开在神经外科危重症病人中的应用价值

目的观察并比较经皮气管切开术（PT）和传统气管切开术（OT）在神经外科危重症监护室（NICU）的应用价值。方法前瞻性随机将84例需气管切开的病人分成胛组及OT组。并对手术操作时间、并发症、拔管后切口愈合时间、颈部疤痕大小等方面进行比较。结果两组手术所需时间、出血量、并发症、颈部疤痕大小比较，P〈0．01；拔管后切口愈合时间比较，P〈0．05。手术并发症胛组2例，OT组12例。结论经皮气管切开术是一项具有操作简单，快速、安全、有效、创伤小、并发症少且术后颈部疤痕小、美观等特点的快速建立长久人工气道的成熟技术。在神经科危重症监护室需行气管切开术的病人应首选该法。

Clinical efficacy of percutaneous tracheostomy and conventional tracheostomy for critical patients in neurosurgery

Objective: To evaluate comparatively the clinical efficacy of Percutaneous tracheostomy and Conventional tracheostomy for critical patients in NICU.Methods A total of 84 patients in whom tracheostomy was needed given randomly either PT or OT.The mean time used for the operations,complications,the wound healing time and sizes of scar after extubating were compared between the two methods.Results The mean time used for the operations,complications and the sizes of scar after extubating were compared between the two methods, P<0.01;the wound healing time after extubating,P<0.05;complications were 2 cases in PT group,but 12 cases in OT group.Conclusion PT is safe,easy to operation,with less trauma scars and complications,and therefore firstly to be applied for critical patients in neurosurgery.