Comparison of the Application of Percutaneous Tracheotomy Guided by Fiberoptic Bronchoscopy and Anatomical Landmark Localization in Intensive Care Unit

JIANG Ren; ZHENG Kaipan; XU Zhuangwen

doi:10.14033/j.cnki.cfmr.2025.36.012

Abstract：Objective:Comparative analysis of the application of fiberoptic bronchoscopy guidance and anatomical landmark localization in percutaneous tracheotomy(PDT)for patients in the intensive care unit(ICU).Method:A prospective study was conducted on 64 ICU patients who received PDT surgery at Huizhou Zhongda Huiya Hospital from January 2022 to October 2024.The patients were randomly divided into an observation group(n=32)and a control group(n=32).The control group received anatomical landmark localization PDT treatment,while the observation group received PDT treatment guided by fiberoptic bronchoscopy.Compare perioperative indicators and incision injuries between two groups.Compare various vital signs indicators between two groups during tracheotomy and tracheal intubation.Compare the inflammatory factors between two groups before surgery and one week after surgery.Calculate the incidence of postoperative complications in two groups.Result:The surgical indicators of the observation group(surgical time,intraoperative blood loss,incision length and healing time,scar area)were superior to those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the duration of mechanical ventilation between the two groups(P>0.05).When inserting tracheal intubation,compared with the control group,the observation group had higher SPO2,lower HR and MAP,and the differences were statistically significant(P<0.05).One week after surgery,compared with the control group,the observation group had lower rates of white blood cell(WBC),neutrophil percentage(NEUT%),C-reactive protein(CRP),procalcitonin(PCT),and postoperative complications,and the differences were statistically significant(P<0.05).Conclusion:Compared with anatomical landmark localization PDT,fiberoptic bronchoscopy guided PDT has more obvious advantages in ICU patients,with less intraoperative bleeding,shorter hospital stay,smaller scar area,and faster wound healing.This method can effectively reduce the level of inflammatory factors,reduce the occurrence of complications,facilitate the stable maintenance of patients'vital signs,and have higher safety.