早期机械通气干预对出血性脑卒中术后低氧血症患者预后的影响研究

发布时间：2018-12-09 21:02

【摘要】：目的探讨早期机械通气干预对出血性脑卒中术后低氧血症患者预后的影响。方法采用前瞻性随机对照研究设计,选取2010年1月—2013年3月河北医科大学附属哈励逊国际和平医院收治的出血性脑卒中术后低氧血症患者144例,采用随机数字表法分为3组,每组48例。A组:积极的早期机械通气干预组,患者术后给予持续末梢血氧饱和度(Sp O_2)及血气分析监测,当持续2 h平均Sp O_2在93%~95%和/或平均动脉血氧分压(Pa O_2)在71~80mm Hg(1 mm Hg=0.133 k Pa),即积极的早期给予机械通气。B组:早期机械通气干预组,当持续2 h平均Sp O_2在91%~92%和/或平均Pa O_2在61~70 mm Hg,给予机械通气。C组:保守机械通气组,待持续2 h平均Sp O_2≤90%和/或平均Pa O_2≤60 mm Hg,才给予机械通气。记录患者呼吸机相关性肺炎(VAP)、术后再出血、脑积水发生率、机械通气持续时间,术后随访6个月时格拉斯哥预后量表(GOS)评分及病死率。结果 3组患者VAP、术后再出血、脑积水发生率及病死率比较,差异均无统计学意义(P0.05)。3组患者机械通气持续时间及GOS评分比较,差异均有统计学意义(P0.05);其中A组和B组患者机械通气持续时间短于C组,GOS评分高于C组(P0.05);A组与B组患者机械通气持续时间及GOS评分比较,差异均无统计学意义(P0.05)。结论早期机械通气能够缩短出血性脑卒中术后低氧血症患者机械通气持续时间,改善预后。
[Abstract]:Objective to investigate the effect of early mechanical ventilation on the prognosis of patients with hypoxemia after hemorrhagic stroke. Methods 144 patients with hypoxemia after hemorrhagic stroke were selected from January 2010 to March 2013 in Hallieson International Peace Hospital of Hebei Medical University. The patients were randomly divided into 3 groups. 48 cases in each group. Group A: positive early mechanical ventilation intervention group, patients received continuous peripheral blood oxygen saturation (Sp O 2) and blood gas monitoring after operation. Mean Sp O _ 2 at 93% and / or mean Pa O _ 2 at 71~80mm Hg (1 mm Hg=0.133 k Pa),) were given early mechanical ventilation in group B.Group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, When the mean Sp O _ 2 lasted for 2 hours, 92% of the patients were given mechanical ventilation at 91% and / or the average Pa O _ 2 at 61 mm Hg,. Group C: conservative mechanical ventilation group, mean Sp O _ 2 鈮，

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