Objective To compare the application effect of percutaneous dilational tracheostomy and modified percuta-neous dilational tracheostomy in the treatment of critically ill patients. Methods A total of 120 critically ill patients undergo-ing tracheotomy were selected, and they were divided two groups according to the methods of tracheotomy. The sex, age, body mass index, acute physiology and chronic health evaluation, operation time, incision size, intraoperative blood loss, inci-sion healing time, incidence of complications after operation were compared between the two groups. Results There were no statistically significant differences of sex, age, weight, body mass index, and acute physiology and chronic health evaluation between Portex percutaneous dilational tracheostomy group (group A) and modified percutaneous dilational tracheostomy group (group B) (P>0.05). The operation time and intraoperative blood loss of group B were significantly shorter than those of group A (P<0.05), and the incision size and incision healing time in the two groups have no statistically significance (P>0.05). Com-pared with group A, tracheal wall injury or perforration of group B were significantly improved (P<0.05). Conclusion The modified percutaneous dilational tracheostomy could save operation time, reduce intraoperative blood loss and tracheal wall injury or perforration, so it's worth of clinical application.%目的 观察比较改良经皮气管切开术在危重症患者中的应用效果.方法 收集2015年1月至2016年1月期间我院重症监护病房(ICU)行经皮气管切开术的120例患者的临床资料,随机分为Portex法经皮气管切开术组60例和改良经皮气管切开术组60例,对两组患者的性别、年龄、体质量指数(BMI)、APCHEⅡ评分等一般情况和两组患者手术所需时间、手术切口大小、术中出血量、拔除气管套管后切口愈合时间以及手术后并发症的发生率进行比较.结果 Portex法经皮气管切开术组与改良经皮气管切开术组相比较,两组患者在性别、年龄、体重指数(BMI)、APCHEⅡ评分等指标方面差异无统计学意义(P>0.05);与Portex法经皮气管切开术组相比较,改良经皮气管切开术组手术时间、术中出血量明显减少(P<0.05),差异有统计学意义,但两组患者的切口大小、切口愈合时间比较差异无统计学意义(P>0.05);改良经皮气管切开术组与Portex法经皮气管切开术组相比,气管后壁损伤或穿孔的发生率明显减少,差异有统计学意义(P<0.05).结论 改良经皮气管切开术与Portex法经皮气管切开术相比较,可节约手术时间、减少术中出血量、减少气管后壁损伤或穿孔的发生率,值得临床推广应用.
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