超声引导下经皮气管切开术在颌面部多发伤并上呼吸道梗阻中的应用

Application of ultrasound-guided percutaneous tracheotomy in multiple maxillofacial injuries with upper respiratory tract obstruction

摘要:

【摘要】目的：探讨超声引导下经皮气管切开术在颌面部多发伤并上呼吸道梗阻中的应用价值。方法：我院重症医学科于2016.5-2020.10对8例颌面部多发伤合并急性上呼吸道梗阻患者气管插管失败后紧急行超声引导下经皮扩张气管切开术。结果：8例患者均一次穿刺成功，穿刺成功率100%；手术时间5~9min，平均6min；患者术中出血量4~12mL；置管成功率100%。无一例发生手术相关并发症。结论：对颌面部多发伤合并急性上呼吸道梗阻患者气管插管失败后紧急行彩色多普勒超声引导下经皮扩张气管切开术不仅可快速、有效、安全开放气道，而且提高成功率，降低手术相关并发症，具有良好的临床价值。

Abstract:

【Abstract】Objective To explore the application value of ultrasound-guided percutaneous tracheotomy in multiple maxillofacial injuries with upper respiratory tract obstruction. Method Eight patients with multiple maxillofacial injuries complicated with acute upper respiratory tract obstruction were treated by the Department of Critical Care Medicine of our hospital from May, 2016 to October, 2020.After tracheal intubation failure, they underwent emergency ultrasonics guided percutaneous dilatation tracheotomy. Result Puncture for 8 patients was successful at one time, and success rate of puncture was 100%; The operation time was 5 ~ 9 min, with an average of 6 min.The amount of intraoperative bleeding was 4 ~ 12ml; The success rate of catheterization was 100%. None of the patients had surgery related complications. Conclusion For patients with multiple maxillofacial injuries complicated with acute upper respiratory tract obstruction, emergency color Doppler ultrasound-guided percutaneous dilated tracheotomy can not only quickly, effectively and safely open the airway after tracheal intubation failure，but also improve the success rate and reduce surgery-related complications, which has good clinical value.