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目的:探讨经皮牛角型扩张器一步法气管切开术的临床应用方法及效果。方法:分析采用经皮牛角型扩张器一步法气管切开术的18例患者的手术时间,观察术中患者呼吸频率、心率、血压及血氧饱和度,出血量及并发症。结果:采用经皮导丝牛角型扩张器一步法气管切开术能一次性顺利扩张造瘘口,气管套管经插入器插入造瘘口顺畅,瘘口与气管切开套管匹配,平均手术时间(6±1.5)min,其中扩张造瘘口时间平均(20±5.5)s,插入气管套管时间平均(12±3)s出血少。术中呼吸频率、心率、血压、血氧饱和度无明显波动,术后出现1例纵隔皮下气肿。结论:经皮牛角型扩张器一步法气管切开术操作安全、简单、快速,值得临床应用推广。
Objective: To explore the clinical application of transcutaneous ciliary horn dilator tracheotomy and its clinical effect. Methods: The operation time of 18 patients who underwent tracheotomy with transcutaneous horns dilator was analyzed. The respiratory rate, heart rate, blood pressure, oxygen saturation, blood loss and complications were observed. Results: One-step tracheostomy with percutaneous guide wire horn type dilator could smoothly expand the stoma at one time. The tracheal tube was inserted into the stoma smoothly through the inserter. The fistula was matched with the tracheostomy tube. The average operation Time was (6 ± 1.5) min, of which the average time of dilating ostomy was (20 ± 5.5) s, and the mean time of insertion of tracheal tube was (12 ± 3) s. Intraoperative respiratory rate, heart rate, blood pressure, oxygen saturation no significant fluctuations, 1 case of subcutaneous emphysema after mediastinal. Conclusion: One-step percutaneous transhormonal dilator tracheostomy is safe, simple and rapid, which is worth popularizing in clinic.