气管切开术的时机对颈髓损伤患者治疗的影响

发布时间：2018-04-20 16:07

本文选题：气管切开 + 颈髓损伤　；参考：《中国矫形外科杂志》2017年14期

【摘要】：[目的]评价需机械通气的颈髓损伤患者,早期及晚期气管切开的时机对其治疗的临床效果及安全性。[方法]回顾性分析本院2008年10月~2014年10月收治的颈髓损伤并行气管切开患者共36例。按气管切开的时机分为早期组及晚期组。观察患者机械通气时间(总时间及气管切开术后的时间),ICU住院时间(总时间及气管切开术后的时间),院内获得性肺炎的发病率,同时评估两组气管切开的并发症。[结果]早期组有明显较短的机械通气时间,包括总机械通气时间[(23.46±2.23)d VS(34.55±4.53)d]和气切后机械通气时间[(15.24±4.74)d VS(25.41±9.74)d],及较短的ICU住院时间[(21.92±5.94)d VS(39.04±15.95)d],两组患者在气管切开后肺炎的发生率无差别(60%VS 80.95%);两组总体并发症的例数,早期组要低于晚期组(1例VS 5例)。[结论]需机械通气的颈髓损伤患者,早期行气管切开术,可减少机械通气时间,减少ICU住院时间及长时间插管的并发症,且并未增加颈椎手术切口感染。但并不能减少与机械通气相关的肺部感染。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of early and late tracheotomy in patients with cervical spinal cord injury requiring mechanical ventilation. [methods] 36 patients with cervical spinal cord injury and tracheotomy from October 2008 to October 2014 were retrospectively analyzed. According to the time of tracheotomy, it was divided into early group and late group. To observe the time of mechanical ventilation (total time and time after tracheotomy) and the time of ICU hospitalization (total time and time after tracheotomy), the incidence of nosocomial pneumonia, and to evaluate the complications of tracheotomy in both groups. [results] the early group had obviously shorter mechanical ventilation time, In the early group, it was lower than that in the late stage group (1 case vs 5 cases). [conclusion] early tracheotomy for patients with cervical spinal cord injury requiring mechanical ventilation can reduce the time of mechanical ventilation, reduce the length of ICU hospitalization and complications of long intubation, and do not increase the infection of incision in cervical spine surgery. But it does not reduce lung infection associated with mechanical ventilation.
【作者单位】：桂林市人民医院脊柱骨病外科;
【分类号】：R651.2

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