The Controlled Clinical Research On The Application Of Percutaneous Tracheostomy And Traditional Tracheostomy In Neurosurgical Intensive Patients

Objectives To discuss the satety of the application of percutaneous tracheostomy(PT) in the neurosurgical intensive patients, and to provide a quick and minimally invasive method of tracheostomy through the comparison of the application of percutaneous tracheostomy and traditional tracheostomy in the neurosurgical intensive patients.Methods This study is a prospective case-control study, a total of 196 severe nerve patients meeting the standards need for tracheostomy hospitalized in the Department of Neurosurgery of North China and university affiliated Caofeidian district hospital and Tangshan Guye Hospital of Traditional Chinese Medicine of Hebei Province from June 2013 to February 2015 were divided into traditional tracheotomy group and percutaneous tracheostomy group. The sex, age, tracheotomy from the time of onsetonset, preoperative Glasgow coma score and the illness of patient were recorded, and the incision size, operation time, the wound healing time and intraoperative bleeding after removal of the tracheal tube,pneumothorax, Subcutaneous emphysema, esophageal injury, Incision infection, tube prolapse, tracheal collapse during operation were recorded and compared between the two groups.Results The operation of all patients meeting the inclusion criteria in the PT group and the traditional group was successfully completed. There are 98 cases in each of the two groups preoperative. In the course of the study, 31 cases of PT group were excluded, 37 cases of traditional group excluded according to the exclusion criteria. 1 Patients of the two groups with gender, age, and tracheal incision from the time of onset, the preoperative Glasgow Coma Scale(GCS), suffering from disease(cerebral vascular disease, brain injury) have no statistical significance(P>0.05). 2 In the PT group, the incision size was(1.23±0.11)cm, the intraoperative bleeding volume was(20.37±3.92)ml, the operation time was(7.63±1.00)min, the healing time of the tracheal tubein was(3.63±0.52)day. In the traditional group,the incision size was(5.34±0.46) cm, the intraoperative bleeding volume was(42.62±7.78)ml,operation time was(41.51±3.78)min, the healing time of the tracheal tubein was(5.89±0.95)day. There was significant difference between the two groups(P<0.05). 3 The complication rate of PT group [7.46%(5/67)] was lower than the traditional group[19.67%(12/61)], There was significant difference between the two groups(P=0.042,<0.05).Conclusions The percutaneous tracheostomy conforms to the minimally invasive technology requirements. Compared with the traditional tracheostomy, the percutaneous tracheostomy can be operated bedside, and produces a smaller incision, less operation time, less bleeding volume, less healing time and a lower complication rate. The percutaneous tracheostomy was a convenient, fast and safe therapeutic Method applying to neurosurgical intensive patients.