早期气管切开联合过度通气在高血压脑出血术后治疗中的应用  

Application of early tracheotomy combined with hyperventilation in the treatment of hypertensive cerebral hemorrhage

作　　者：宋钦[1] 

机构地区：[1]东莞市虎门医院神经外科,广东省东莞523900

出　　处：《中国基层医药》2013年第11期1626-1628,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨早期气管切开联合过度通气在高血压脑出血术后患者治疗中的作用。方法 回顾性分析76例高血压脑出血术后患者的临床资料,根据是否早期气管切开联合过度通气,分为治疗组和对照组。治疗3个月后根据格拉斯哥昏迷计分（GCS）对两组患者进行预后评价并比较。结果 治疗组36例,良好10例,轻残10例,重残9例,植物状态3例,死亡4例;对照组40例,良好7例,轻残7例,重残11例,植物状态5例,死亡10例,治疗组疗效明显好于对照组（χ2=6.290,P=0.043）。治疗组36例,电解质紊乱5例,肾功能损害6例,应激性溃疡8例,肺部感染8例。对照组40例,电解质紊乱11例,肾功能损害10例,应激性溃疡11例,肺部感染15例。治疗组的并发症发生率明显低于对照组（χ2=8.316,P=0.020）。结论 对于高血压脑出血术后患者,早期气管切开联合过度通气治疗,有效提高了患者的生存率和生存质量。Objective To explore the effect of early tracheotomy combined with hyperventilation in the treatment of hypertensive cerebral hemorrhage.Methods Clinical data of 76 patients with hypertensive cerebral hemorrhage after operation were retrospectively analyzed,and they were divided into treatment group and control group depending on whether received early tracheal incision joint hyperventilation.3 months after the treatment,the prognosis of the two groups was evaluated and compared according to the Glasgow Coma Score（GCS）.Results In the treatment group,there were good in 10 cases,mild disability in 10 cases,severe disability in 9 cases,vegetative state in 3 cases,deaths in 4 cases.In the control group,there were good in 7 cases,mild disability in 7 cases,severe disability in 11 cases,vegetative state patients in 5 cases,deaths in 10 cases,and the efficacy of the treatment group was significantly better than that of the control group（χ2=6.290,P= 0.043）.In the treatment group,there were 5 cases of electrolyte imbalance,6 cases of kidney dysfunction,8 cases of stress ulcer,8 cases of lung infection.In the control group,there were 11 cases of electrolyte disturbances,10 cases of renal dysfunction,11 cases of stress ulcer,15 cases of lung infection.The incidence rate of complications of the treatment group was significantly lower than the control group（χ2=831.6,P=0.020）.Conclusion For hypertensive cerebral hemorrhage,early tracheotomy combined with hyperventilation treatment can improve the patients＇ survival rate and life quality.

关 键 词：颅内出血 高血压性 气管切开术 通气过度 预后 

分 类 号：R651.1[医药卫生—外科学]