管切开时机对老年颅脑损伤患者肺部感染影响的研究  

The effect of tracheotomy timing in elder patients who got traumatic brain injury： a retrospective study

作　　者：陈谦[1] 王家东[1] 

机构地区：[1]上海交通大学医学院附属仁济医院耳鼻咽喉头颈外科上海交通大学耳鼻咽喉科研究所,上海市200127

出　　处：《老年医学与保健》2011年第1期52-54,57,共4页Geriatrics & Health Care

摘　　要：目的探讨选择在不同气管切开时机的拔管率、肺部感染发生率和死亡率的差异。方法选取老年颅脑损伤患者41例，收集患者的年龄、性别、格拉斯哥昏迷评分（GCS）、发病至气切的时间、平均置管时间及拔管率、预后。其中颅脑损伤后72h内气切者有25例，称为A组，72h以后气切者有16例，称为B组。结果在性别（P=0．185）、年龄（P=0．078）、昏迷指数水平GCS（P=0．922）差异无统计学意义的情况下，其病死率差异无统计学意义（P=0．354），拔管率差异无统计学意义（P=0．493），肺部感染率差异（P=0．033），A组小于B组。结论老年颅脑损伤患者，在具有气管切开手术指征的情况下，颅脑外伤后72h内行气管切开术可降低其肺部感染率。Objective To discuss the difference of wean rate, pneumonia rate and mortality between different tra- cheotomy timing. Methods Forty-one elderly patients with traumatic brain injury were divided into two groups： tracheotomy during 72 hours group （group A, n=25） and tracheotomy after 72 hours group （group B, n= 16）. Age, sex, GCS, length of time before undergoing tracheotomy, weaning rate were assessed and analyzed. Results A total of 41 patients （28 men and 13 women） were included. There were no differences in age （P=0.078）, sex （P=0.185）, and GCS （P=0.922） between the two groups. Patients in group A had lowerpneumonia rate, compared with group B （P=0.033）. Conclusion Patients with traumatic brain injury, undergoing tracheotomy in 72 hours, have a lower pneumonia rate.

关 键 词：气管切开时机 老年患者 颅脑损伤 

分 类 号：R651.15[医药卫生—外科学]