不同时机行气管切开术对脑干损伤患者影响的研究

发布时间：2018-12-15 04:52

【摘要】：目的：探讨脑干损伤后不同时机下行气管切开术对患者治疗效果及治疗过程的影响。方法：选取脑干损伤后给予气管切开患者79例,依据是否在脑干损伤72小时以内给予气管切开,分为A、B两组,其他治疗相同。将两组资料对比分析,研究脑干损伤后不同时机行气管切开术对患者治疗效果及过程的影响。结果：从治疗效果上来看,A、B两组患者在清醒率、持续意识障碍率及死亡率上的差异无统计学意义(P=0.657)；对A、B两组患者在不同病因上分层比较,脑出血所致脑干损伤患者在不同时机行气管切开间的治疗效果的差异有统计学意义(P=0.011),脑外伤所致脑干损伤患者在不同时机行气管切开间的治疗效果的差异有统计学意义(P=0.001)。从治疗过程上来看,(1)在最终清醒的患者中,不同时机行气管切开术下患者清醒所用的时间无统计学意义(P=0.620)；(2)在持续意识障碍的患者中,不同时机行气管切开术下患者格拉斯哥评分的恢复无统计学意义(P=-0.153)；(3)在最终死亡的患者中,不同时机行气管切开术下患者生存时间的差异比较的P值(P=0.057)接近0.05,因样本量较少,有待进一步扩大样本含量,方可下结论。结论：并非所有的脑干损伤患者都能从早期气管切开中受益。不同病因导致的脑干损伤在不同时机下行气管切开术的治疗效果可能存在差异。气管切开时机不同的清醒的患者,其清醒所用的时间可能无差异。气管切开时机不同的持续意识障碍的患者,格拉斯哥评分恢复的情况可能无差异。
[Abstract]:Objective: to investigate the effect of tracheotomy after brain stem injury. Methods: Seventy-nine patients with brain stem injury were treated with tracheotomy. According to whether the patients were given tracheotomy within 72 hours after brain stem injury, they were divided into two groups: group A and group B, other treatments were the same. The effect of tracheotomy at different time after brain stem injury on the treatment effect and process of patients was studied by comparing and analyzing the data of the two groups. Results: there was no significant difference in the rate of wakefulness, the rate of persistent disturbance of consciousness and the death rate between the two groups (P0. 657). There was significant difference in the therapeutic effect between the patients with brain stem injury caused by intracerebral hemorrhage in different time after tracheotomy (P0. 011). There was significant difference in the therapeutic effect between the patients with brain stem injury after tracheotomy at different time (P0. 001). From the point of view of the treatment process, (1) there was no significant difference in the time taken for the patients to wake up under tracheotomy at different times (P0. 620). (2) the recovery of Glasgow score in patients with persistent disturbance of consciousness was not statistically significant under tracheotomy at different times (Pfi-0.153). (3) among the patients with final death, the difference of survival time between the patients undergoing tracheotomy at different times (P0. 057) was close to 0. 05. Because of the small sample size, the sample size needed to be further expanded before the conclusion could be drawn. Conclusion: not all brain-stem injury patients benefit from early tracheotomy. The effect of tracheotomy on brain stem injury caused by different etiology may be different. There may be no difference in the duration of recovery in patients with different tracheotomy timing. There may be no difference in the recovery of Glasgow score in patients with persistent consciousness disorders at different tracheotomy times.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R651.15

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