不同气管切开时机对重型颅脑损伤患者肺部感染的疗效研究

发布时间：2018-04-17 06:26

本文选题：气管切开 + 重型颅脑损伤　；参考：《中华医院感染学杂志》2017年19期

【摘要】：目的探究不同气管切开时机对救治重型颅脑损伤并发肺部感染患者的疗效影响,为更好的救治患者提供科学依据。方法选取2013年8月-2016年8月于医院治疗的重型颅脑损伤并发肺部感染的68例患者临床资料进行回顾性分析,按不同气管切开时机分为观察组39例和对照组29例,观察组患者实行早期气管切开,对照组患者实行晚期气管切开,对两组患者感染的病原菌进行分析,在手术前后检测两组患者动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)和血氧饱和度(SaO_2),对两组患者进行格拉斯哥昏迷指数评估(GCS评分)并比较,同时检查两组患者肺部感染改善情况,比较两组患者不良反应发生率。结果患者肺部感染病原菌多为革兰阴性菌,主要感染病原菌为铜绿假单胞菌和金黄色葡萄球菌,分别占26.47%、23.54%;术前两组患者PaO_2、PaCO_2和SaO_2数据及格拉斯哥昏迷评估情况差异无统计学意义,术后观察组上述指标均优于对照组,且比较差异有统计学意义(P0.05);观察组患者肺部感染改善有效率为82.05%,对照组有效率为65.52%;观察组患者不良反应发生例数也少于对照组,两组患者数据差异有统计学意义(P0.05)。结论在救治重型颅脑损伤并发肺部感染患者的过程中,应掌握好气管切开时机。
[Abstract]:Objective to explore the effect of different tracheotomy time on the treatment of patients with severe craniocerebral injury complicated with pulmonary infection, and to provide scientific basis for better treatment of patients.Methods the clinical data of 68 patients with severe craniocerebral injury complicated with pulmonary infection who were treated in hospital from August 2013 to August 2016 were retrospectively analyzed. According to the different tracheotomy time, the patients were divided into observation group (39 cases) and control group (29 cases).The patients in the observation group were treated with early tracheotomy, the patients in the control group were treated with late tracheotomy, and the pathogens of infection in the two groups were analyzed.Before and after operation, the patients in the two groups were examined for Pao _ 2, Paco _ 2) and Sao _ 2O _ 2. The Glasgow coma index (Glasgow coma index) and the GCS score were compared. At the same time, the improvement of pulmonary infection in the two groups was examined.The incidence of adverse reactions was compared between the two groups.Results most of the pathogens of pulmonary infection were Gram-negative bacteria, and the main pathogens were Pseudomonas aeruginosa and Staphylococcus aureus, accounting for 26.47 and 23.54, respectively. There was no significant difference between the two groups in the data of Pao _ 2C _ 2 and SaO_2 and the assessment of Glasgow coma before operation.The improvement rate of pulmonary infection in the observation group was 82.05, the effective rate in the control group was 65.52, the number of adverse reactions in the observation group was also less than that in the control group.The difference between the two groups was statistically significant (P 0.05).Conclusion in the treatment of severe craniocerebral injury complicated with pulmonary infection, we should grasp the opportunity of tracheotomy.
【作者单位】：儋州市人民医院神经外科;
【分类号】：R563.1;R651.15

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