摘要： 脑出血或脑梗死复发并发肺感染患者再次行气管切开术时，以原切口气管环下方造瘘手术难度相对较小、危险性低且手术时间相对较短，尤其适用于甲状腺体积较大患者；术前存在气管狭窄患者，推荐在原气管环造瘘处剔除瘢痕组织，放置8 号带气囊气管套管，扩张气管。术后切口部位出血或渗血，以油纱条或碘仿填塞止血24 ~ 48 h即可。

关键词: 气管切开术, 脑出血, 脑梗死, 肺炎

Abstract: Objective To explore the surgical management of second tracheotomy. Methods Retrospective analysis of 32 cases with recurrent cerebrovascular disease or pulmonary infection who under-went second tracheotomy in our hospital from 2008 to 2010. Results These 32 cases were operated successfully without complication. Among these cases, 6 patients occurred hemorrhage after operation and the hemostatic effect was good. Conclusion Second tracheotomy is difficult. It depends on the first tracheotomy condition and the trachea exposure to decide the operation mode and incision position.

Key words: Tracheotomy, Cerebral hemorrhage, Cerebral infarction, Pneumonia