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目的：研究经皮扩张气管切开术在重症脑出血患者抢救中应用价值。方法：选取 2010 年 1 月至 2013 年 12 月在我院诊治的 80 例重度脑出血患者，根据自愿原则， 40 例采用经皮扩张气管切开术进行抢救治疗为观察组，其余 40 例采用传统气管切开术治疗为对照组，比较两组患者术中平均出血量、手术时间、术后切口愈合时间、颈部疤痕情况以及术后并发症发生率。结果： ① 观察组患者较对照组术中出血量少、手术时间及术后切口愈合时间较短、颈部伤疤小，两组比较差异有统计学意义（ P＜ 0.05）； ② 观察组患者并发症发生率为 7.5%，明显低于对照组的 22.5%，比较差异有统计学意义（ P＜ 0.05）。结论：经皮扩张气管切开术抢救重症脑出血合并呼吸道梗阻具有操作简单，创伤小，愈合快且并发症少的优势，值得临床推广应用。

英文摘要:

Objective:To observe the application value of percutaneous dilational tracheostomy in rescue of patients with severe cerebral hemorrhage.Methods:80 cases ofpatients with severe cerebral hemorrhage from January 2010 to December 201 3 in our hospital were selected, according to the principle of voluntary,40 cases of them given percutaneous dilational tracheostomy for treatment were set as the observation group, the other 40 cases that received traditional tracheotomy were set as the control group. The average amount of bleeding, average operation time, postoperative wound healing time, neck scar condition and the incidence of postoperative complications of the two groups were compared.Results:① The patients in the observation group had less bleeding, shorter operation time, postoperative wound healing timeand smaller the neck scar when compared with those of the control group, the difference was significant (P<0.05); ② The incidence of complications of the observation group was 7.5%, significantly lower than that of the control group(22.5%), and the difference was statistically significant (P<0.05).Conclusion:Percutaneous dilational tracheostomy in rescue of severe cerebral hemorrhage complicated with respiratory tract obstruction has the advantages of simple operation, small trauma ,fast healing and fewer complications, it is worthy of clinical application.

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