检索结果-内蒙古大学图书馆

医学临床研究 2017年第5期34卷 943-945页

作者：林荔青傅西安吴敏娅钱苏荣江苏省苏州市立医院神经外科江苏苏州215008

【目的】分析导丝扩张钳技术行经皮微创气管切开术在重症脑卒中患者抢救中的应用价值。【方法】选择2014年10月至2016年5月本院收治的90例重症脑卒中患者的临床资料。按治疗方式分为开放组（n=40，行开放性气管切开术）与微创组（n=50... 详细信息

【目的】分析导丝扩张钳技术行经皮微创气管切开术在重症脑卒中患者抢救中的应用价值。【方法】选择2014年10月至2016年5月本院收治的90例重症脑卒中患者的临床资料。按治疗方式分为开放组（n=40，行开放性气管切开术）与微创组（n=50，行微创经皮扩张气管切开术），比较两组切口长度、手术时间、术中出血量、切口愈合时间，记录两组围术期及术后3个月并发症发生情况。【结果】微创组手术时间、切口愈合时间均短于开放组，差异均具有统计学意义（均P〈0．05）；微创组切口长度短于开放组，术中出血量少于对照组，差异均具有统计学意义（均P〈0．05）。微创组围术期各并发症发生率均低于开放组，但其中仅出血、皮下气肿、甲状腺损伤发生率比较，差异有统计学意义（x^2=3．937，均P〈0．05）；且微创组术后3个月各并发症发生率均略低于开放组，但其中仅气管狭窄、内芽／瘢痕形成发生率比较，差异有统计学意义（x^2=3．937、5．235，均P〈0．05）。【结论】采用导丝扩张钳技术行经皮微创气管切开术可畅通重症脑卒中患者呼吸道，缩短手术时间，减少术中出血，降低术后并发症发生率。

关键词：卒中/外科学气管切开术气管造口术/方法外科手术,微创性

来源：评论

学校读者我要写书评

暂无评论

Confirming tracheal cannulation during percutaneous tracheostomy without endoscopic guidance

引用

ANAESTHESIA 2003年第10期58卷 1027-1028页

作者： Honan, D Malkan, D Tierney, E Wexford Gen Hosp Wexford Ireland

来源：评论

学校读者我要写书评

暂无评论

128例经皮扩张气管造口术的临床观察

引用

广东医学院学报 2001年第3期19卷 213-214页

作者：刘新姚华国邵义明广东医学院附属医院麻醉科广东湛江524001

目的 :观察改良的经皮扩张气管造口术 (PCDT)的实用性和安全性。方法 :对 12 8例需气管切开的危重病人实施三叶钳暴露气管腔、直视下插入气管导管的改良法 PCDT;记录操作时间、切口大小、伤口愈合时间及并发症等。结果 :12 8例中 92例... 详细信息

目的 :观察改良的经皮扩张气管造口术 (PCDT)的实用性和安全性。方法 :对 12 8例需气管切开的危重病人实施三叶钳暴露气管腔、直视下插入气管导管的改良法 PCDT;记录操作时间、切口大小、伤口愈合时间及并发症等。结果 :12 8例中 92例康复出院 ,死亡 36例 (因脑疝、多器官功能衰竭等死亡 ,非经皮扩张气管造口术所致 )。 12 8例的手术操作时间 (11.5± 4.2 ) min,切口长度 (1.5± 0 .2 ) cm。 12 8例中出现皮下气肿 4例 (均为机械通气的患者 ) ,另有 2例切口感染和 1例操作中出血。出院前未发生有临床症状的气管狭窄和声音改变等远期并发症。所有存活患者的切口在气管导管拔除后 2～ 4d内愈合 ,且无明显疤痕。结论 :改良的 PCDT创伤小 ,并发症少 ,手术操作简便易行 ,具有较高的安全性和实用性。

关键词：气管造口术/方法并发症切口

来源：评论

学校读者我要写书评

暂无评论

Bedside percutaneous tracheostomy: Prospective evaluation of a modification of the current technique in 100 patients

引用

WORLD JOURNAL OF SURGERY 2000年第9期24卷 1109-1115页

作者： Velmahos, GC Gomez, H Boicey, CM Demetriades, D Univ So Calif Dept Surg Los Angeles CA 90093 USA Univ So Calif Los Angeles Cty Med Ctr Los Angeles CA 90033 USA

Percutaneous dilatational tracheostomy (PDT) is being increasingly used. Concerns have been raised as to its safety, especially when it is done at the bedside. A prospective evaluation was conducted of 100 consecutive, unselected critically ill patients with PDT. The mean intensive care unit (ICU) stay before PDT was 12 days. One surgeon performed PDT alone (5 cases) or assisted residents (95 cases) in all operations;84 were performed at the ICU bedside. Only the first six patients were taken to the operating room solely for tracheostomy. A modified technique was used: (1) the endotracheal tube was left in place during sequential dilations;(2) dilators were inserted in a 60-degree cephalad orientation to the skin and directed caudally after penetration of the anterior tracheal wall;(3) a digit was inserted through the tracheal opening to guide withdrawal of the endotracheal tube to the level of the vocal cords;and (4) size 8 tracheostomy cannulas were inserted over 28F dilators. The average time from skin incision to insertion of the tracheostomy tube was 12 minutes (< 10 minutes, 41 patients;10 to 15 minutes, 37 patients;> 15 minutes, 22 patients). Sixty-five percent had unfavorable anatomic conditions due to spinal precautions or diffuse neck edema. Postoperative complications occurred in four patients;surgical emphysema after tracheal lacerations in three, cannula dislodgment in one, All complications were successfully managed without an operation by tube exchange (n = 3) or observation (n = 1);there was no procedure-related mortality. Forty patients were available for long-term follow-up (6-18 months after tracheostomy) by telephone;one had persistent hoarseness without respiratory difficulty. We concluded that bedside PDT is safe and easy to teach when performed with a technique that ensures correct instrumentation.

关键词：插管法气管内前瞻性研究气管造口术/副作用气管造口术/方法成年人女(雌)性人类男(雄)性

来源：评论

学校读者我要写书评

暂无评论

Surgical airway management in the intensive care unit

引用

CRITICAL CARE CLINICS 2000年第3期16卷 473-+页

作者： Pryor, JP Reilly, PM Shapiro, MB Univ Penn Sch Med Div Trauma & Surg Crit Care Philadelphia PA 19104 USA

Tracheostomy is one of the most common surgical procedures performed on critically ill and injured patients in the United States today. Despite decades of experience among surgeons, there is still controversy over specific indications, techniques, and timing of performing the surgical airway New techniques, such as percutaneous dilatational tracheostomy and minitracheostomy, have challenged critical care physicians to tailor operative airway methods to each individual patient. Older procedures, such as cricrothyroidotomy, have found a new niche in the intensive care unit. These new techniques, along with new ways to perform traditional tracheostomies, have made the practice of operative airway management dynamic and controversial.

关键词：气道阻塞/外科学危重病重症监护/方法重症监护/统计学和数值数据重症监护/发展趋势病人遴选床旁诊断化验信息系统时间因素气管造口术/仪器和设备气管造口术/方法人类

来源：评论

学校读者我要写书评

暂无评论

Analysis of tracheostomy-associated morbidity after operations for head and neck cancer

引用

BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 2000年第5期38卷 509-512页

作者： Halfpenny, W McGurk, M Guys Hosp Dept Oral & Maxillofacial Surg London SE1 9RT England

Tracheostomy is a safe and effective way of securing the airway in patients who have radical resections for head and neck cancer. We audited the morbidity after 265 tracheostomies to identify the risks in relation to head and neck surgery, and to propose recommendations to improve care. Twenty-one tracheostomy-related complications were encountered in 256 patients (8%). Most complications occurred during the early postoperative period (72%). There were no tracheostomy-related deaths. Tracheostomies were retained for a median of 10 days (range 1-160). Delayed extubation was associated with extent of resection [P = 0.006], site of tumour (floor of mouth and anterior two thirds of tongue [P = 0.02]), and age (<61 years [P = 0.02]). Patients who were given preoperative radiotherapy were significantly more likely to develop a tracheostomy-related complication (P = 0.03). Patients with a tracheostomy complication were more likely to have other serious complications (P 0.05) and in these patients there was a risk of delayed extubation (P = 0.06). We conclude that elective tracheostomy is essentially event-free, and most complications occur in the ward. (C) 2000 The British Association of Oral and Maxillofacial Surgeons.

关键词：头颈部肿瘤/护理头颈部肿瘤/外科学手术后医护/护理手术后并发症/病因学手术后并发症/护理比例危险度模型危险因素时间因素气管造口术/方法气管造口术/护理气管造口术/统计学和数值数据青少年成年人老年人老年人 80以上儿童女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Exchange of tracheostomy tubes in an infant

引用

PAEDIATRIC ANAESTHESIA 2000年第1期10卷 114-114页

作者： Asai, T Morikawa, T Shingu, K Kansai Med Univ Dept Anesthesiol Moriguchi Osaka 5708507 Japan

来源：评论

学校读者我要写书评

暂无评论

The role of fiberoptic bronchoscopy in airway management of the critically ill patient

引用

CRITICAL CARE CLINICS 2000年第3期16卷 445-+页

作者： Weiss, YG Deutschman, CS Hebrew Univ Jerusalem Hadassah Med Sch Hadassah Univ Hosp Dept Anesthesiol IL-91010 Jerusalem Israel

Fiberoptic bronchoscopes (FOB) play a pivotal role in airway management in the operating room and critical care environments. This article examines the role of FOBs in modern airway management based on a review of rec... 详细信息

关键词：气道阻塞/治疗支气管镜/供应和分配支气管镜检查/方法危重病人医疗/方法危重病纤维光学/仪器和设备纤维光学/方法插管法气管内/仪器和设备插管法气管内/方法气管造口术/仪器和设备气管造口术/方法人类

来源：评论

学校读者我要写书评

暂无评论

Subperiosteal release of the floor of the mouth musculature in two cases of Pierre Robin sequence

引用

Ear, Nose and Throat Journal 2000年第10期79卷 816-819页

作者： Siddique, S. Haupert, M. Rozelle, A. Dept. of Pediatric Otolaryngology Children's Hospital of Michigan Detroit MI 48201 3901 Beaubien United States

Many management approaches have been considered to relieve upper respiratory obstruction in patients with Pierre Robin sequence, but the choice of treatment is determined by the severity of the obstruction. These options include prone positioning, the use of a nasal trumpet, and surgery. One surgical technique is the subperiosteal release of the floor of the mouth musculature. The theory behind this procedure is that this musculature is under tension, and therefore it pushes the tongue upward and backward, resulting in respiratory obstruction. In theory, the release of this musculature from the mandible should alleviate the tension and hence clear the obstruction. In an attempt to objectively evaluate this theory, we performed subperiosteal release surgery on two infants. Our first patient required an emergent tracheostomy on postoperative day 2 because of the onset of surgically induced airway edema. To avoid this complication in the second patient, we performed a tracheostomy at the same time as surgery. Pre- and postoperative magnetic resonance imaging in the second patient revealed only a minimal change in the anatomy of the floor of the mouth musculature. We believe the subperiosteal release of the floor of the mouth musculature requires further evaluation before it can be considered to be effective in the surgical treatment of respiratory obstruction in Pierre Robin sequence.

关键词：气道阻塞/病因学气道阻塞/外科学磁共振成像口底/外科学肌/外科学耳鼻喉外科手术/方法 PierreRobin综合征/并发症 PierreRobin综合征/外科学手术后医护疾病严重程度指数气管造口术/方法女(雌)性人类婴儿男(雄)性

来源：评论

学校读者我要写书评

暂无评论

Translaryngeal tracheostomy through the intubating laryngeal mask airway in a patient with difficult tracheal intubation

引用

INTENSIVE CARE MEDICINE 2000年第6期26卷 820-820页

作者： Quinio, P Deghelt, A Savry, C Bossard, D Robaux, MA de Tinteniac, A Univ Hosp Brest Surg Intens Care Unit F-29609 Brest France

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：