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目的:观察纤维支气管镜（纤支镜）辅助经皮气管切开术（PDT-FOB）对ICU中抗血小板治疗神经重症患者的临床疗效。方法:回顾性收集2020年1月至7月在广东三九脑科医院重症医学科住院接受抗血小板治疗后行经皮气管切开术（PDT）的患者共42例，收集患者临床资料（年龄、性别、基础疾病、抗血小板治疗病因及药物种类、凝血指标、气管切开术式）、术中情况（痰液飞溅、一次穿刺成功、手术时间、转传统切开术、气道后壁损伤、气道内血痂）、术后并发症情况（切口渗血、切口感染、气胸、皮下气肿）。首先根据术式选择分为PDT组和PDT-FOB组，分析术中及术后情况差异；然后根据救治疗效分为满意组及非满意组，采用二元logistic回归法分析抗血小板治疗者疗效的影响因素。结果:PDT-FOB组术中气道后壁损伤、气道内血痂及术后切口感染率分别为9.1%（2/22）、22.7%（5/22）、9.1%（2/22），均低于PDT组15.0%（3/20）、35.0%（7/20）、30.0%（6/20），差异均有统计学意义（均n P＜0.05）。进一步分析发现双联抗血小板药物应用是该类患者救治欠佳的危险因素（n OR=1.085，95%n CI：1.055～1.099，n P＜0.05），而PDT-FOB提高其救治疗效（n OR=6.068，95%n CI：1.295～28.427，n P＜0.05）。n 结论:神经重症患者接受抗血小板治疗期间选择PDT-FOB可以有效降低围术期并发症、减少暴露风险、提高救治效率，值得推广。“,”Objective:To observe the clinical efficacy of percutaneous dilatational tracheotomy assisted by fiberoptic bronchoscope (PDT-FOB) in the treatment of neurological intensive patients undergoing antiplatelet therapy in ICU.Methods:A total of 42 patients undergoing percutaneous dilatational tracheotomy (PDT) after antiplatelet therapy in the intensive care unit of Guangdong 999 Brain Hospital from January to July 2020 were reviewed. The clinical data (age, gender, basic diseases, etiology and drug types of antiplatelet therapy, coagulation function, and types of tracheotomy), intraoperative conditions (spatter of sputum, once puncture success rate, operation time, transfer to traditional tracheotomy, airway posterior wall injury, and blood scab in airway), and postoperative complications (bleeding, infection, pneumothorax, and subcutaneous emphysema) were observed. First, the patients were divided into a PDT group and a PDT-FOB group according to the operation types, and the differences in the intraoperative and postoperative conditions were analyzed. Then they were divided into a satisfaction group and a non-satisfaction group according to the clinical efficacy, and the influencing factors of clinical efficacy of patients undergoing antiplatelet therapy were analyzed by the binary logistic regression method.Results:The incidences of intraoperative airway posterior wall injury, blood scab in airway, and postoperative incision infection in the PDT-FOB group were 9.1% (2/22), 22.7% (5/22), and 9.1% (2/22), which were lower than those in the PDT group [15.0% (3/20), 35.0% (7/20), and 30.0% (6/20)], with statistically significant differences (all n P<0.05). Further analysis showed that dual antiplatelet drug application was a risk factor of poor clinical efficacy in these patients (n OR=1.085, 95%n CI: 1.055-1.099, n P<0.05), while PDT-FOB improved the clinical efficacy (n OR=6.068, 95%n CI: 1.295-28.427, n P<0.05).n Conclusion:PDT-FOB is worth promoting since it can effectively reduce perioperative complications, reduce exposure risk, and improve treatment efficacy for neurological intensive patients undergoing antiplatelet therapy.