早期气管切开对重型颅脑损伤患者肺部感染及预后的影响

发布时间：2018-07-23 19:12

【摘要】：目的分析早期气管切开术对重型颅脑损伤患者肺部感染发生率、控制率、控制时间及重型颅脑损伤患者的病死率,研究早期气管切开对重型颅脑损伤患者肺部感染及预后的影响。方法选取2010-2013年进行诊治的重型颅脑损伤患者120例,随机分为治疗组和对照组,每组各60例,两组患者均采用相同的治疗方案,治疗组在颅脑损伤后24h内行气管切开术,对照组在损伤后24h行气管切开术,比较两组患者肺部感染感染率、控制率、控制时间及两组患者的病死率。结果重型颅脑损伤患者并发肺部感染发生率,治疗组为31.67%,对照组为86.67%;19例早期气管切开重型颅脑损伤并发肺部感染患者得到控制16例,控制率为84.21%,对照组52例重型颅脑损伤并肺部感染患者得到控制25例,控制率为48.08%;肺部感染控制时间治疗组患者平均为(7.3±2.9)d,对照组为(14.4±4.5)d,重型颅脑损伤患者病死率治疗组为13.33%、对照组为45.00%,早期行气管切开术明显降低了重型颅脑损伤患者的病死率。结论早期行气管切开术应作为重型颅脑损伤患者临床常用的治疗方案进行推广。
[Abstract]:Objective to analyze the incidence, control time and mortality of lung infection in patients with severe craniocerebral injury after early tracheotomy. To study the effect of early tracheotomy on pulmonary infection and prognosis in patients with severe craniocerebral injury. Methods 120 patients with severe craniocerebral injury from 2010 to 2013 were randomly divided into treatment group (n = 60) and control group (n = 60). The patients in the control group were treated with tracheotomy 24 hours after injury. The lung infection rate, the control time and the fatality rate of the two groups were compared. Results the incidence of pulmonary infection in patients with severe craniocerebral injury was 31.67 in the treatment group and 86.67 in the control group. The control rate was 84.21. The control group consisted of 52 patients with severe craniocerebral injury and pulmonary infection. The control rate was 48.08, the mean time of pulmonary infection control was (7.3 卤2.9) days in the treatment group, (14.4 卤4.5) days in the control group, 13.33 in the treatment group and 45.00 in the control group. Early tracheotomy significantly reduced the mortality of the patients with severe craniocerebral injury. Conclusion early tracheotomy should be widely used in the treatment of severe craniocerebral injury.
【作者单位】：三峡大学仁和医院神经外科;三峡大学仁和医院骨科;三峡大学仁和医院心内科;
【基金】：湖北省卫生厅研究基金资助项目(JXSA09)
【分类号】：R563.1

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