经皮微创气管切开术在ICU中的应用

目的 探讨经皮微创气管切开术在ICU中的应用体会.方法 2006年5月～2013年5月对65例危重病患者施行经皮微创气管切开术,气管前壁造口,扩张钳逐步扩张,导丝引导下放入气管切开套管.结果 65例手术均成功,手术时间9~45 min,（19.7±6.9） min.术中出血量〈10 ml.65例术后气管切开套管处皮肤一直保持清洁,未发现窦道及周围软组织感染.拔除气管切开导管后31例随访12个月,无气管狭窄、发音异常等并发症出现,美容效果良好.结论 经皮微创气管切开术对于ICU中的危重患者是一个良好的选择.

Application of Percutaneous Minimally Invasive Tracheostomy in ICU

Objective To explore the application of percutaneous minimally invasive tracheotomy in ICU. Methods From May 2006 to May 2013, 65 critical patients underwent minimally invasive tracheostomy. After an incision was made on the anterior tracheal wall, dilating forceps were used to expand gradually, finally tracheotomy tube was inserted guided by the conducting wire. Results All the 65 operations were completed successfully. The operation time was 9 - 45 min, with a mean of 19.7 min and the blood loss was less than 10ml. Thirty-one cases were followed up for 12 months after the removal of cathether, and no tracheostenosis, abnormal articulation or other complications occurred. The cosmetic effect was favorable. Three cases of cerebral hemorrhage underwent recurrent pulmonary infections following operation, which led to intubation time more than 60 days. Conclusion Percutaneous minimally invasive tracheostomy is an effective procedure for critically ill patients in ICU.