脑卒中肺部感染患者气管切开时机对预后的影响

发布时间：2018-02-14 11:32

本文关键词： 气管切开时机肺部感染预后　出处：《中华医院感染学杂志》2014年14期 　论文类型：期刊论文

【摘要】：目的探讨脑卒中肺部感染患者气管切开时机对预后的影响,以降低肺部感染率。方法回顾性分析2009-2012年ICU脑卒中肺部感染经皮气管切开的患者60例,按手术时间分成早期气管切开(观察组)和延迟气管切开(对照组),每组各30例,比较两组患者病死率和肺部感染好转率、GCS评分、SIRS持续时间、CPIS评分、机械通气时间、ICU住院时间和气管切开手术并发症发生率差异。结果经皮气管切开均成功,观察组肺部感染好转率为56.67%,高于对照组的30.00%(P0.05),两组病死率差异无统计学意义;观察组患者SIRS持续时间、CPIS评分、机械通气时间、ICU住院时间均短于对照组(P0.05),并发症发生率及病死率观察组分别为23.33%、16.67%,低于对照组的30.00%、20.00%,但差异无统计学意义。结论早期气管切开可以明显缩短机械通气时间和ICU住院时间,临床医师需综合判断病情,根据GCS评分、CPIS评分、机械通气时间等个体化选择气管切开时间。
[Abstract]:Objective to investigate the influence of tracheotomy time on the prognosis of patients with pulmonary infection after stroke and to reduce the pulmonary infection rate. Methods 60 patients with pulmonary infection following ICU from 2009 to 2012 were retrospectively analyzed. The patients were divided into early tracheotomy (observation group) and delayed tracheotomy (control group, 30 cases in each group) according to the operation time. Results the improvement rate of pulmonary infection in the observation group was 56.67, which was higher than that in the control group (P 0.05). There was no significant difference in the mortality between the two groups. In the observation group, the duration of SIRS and the score of CPIS were observed. The duration of mechanical ventilation in ICU was shorter than that in the control group (P 0.05). The incidence of complications and mortality in the observation group were 23.33 and 16.67, respectively, which were lower than those in the control group, but the difference was not statistically significant. Conclusion early tracheotomy can significantly shorten mechanical ventilation. Time and ICU stay, The clinician should judge the condition synthetically, select tracheotomy time according to GCS score, mechanical ventilation time and so on.
【作者单位】：郑州人民医院神经内科;
【基金】：河南省医学科技攻关计划基金资助项目(201203047)
【分类号】：R563.1;R743.3

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