重症高血压脑出血术后气管切开手术时机及预后探讨  

The tracheotomy timing and its outcome in severe hypertensive intracerebral hemorrhage patients

作　　者：于强[1] 黄好峰 李习珍 胡海成[1] 李春[1] 张成[1] 韩超[1] 曹祥记 

机构地区：[1]安徽省阜阳市第五人民医院脑外科,236001

出　　处：《蚌埠医学院学报》2015年第5期609-611,共3页Journal of Bengbu Medical College

摘　　要：目的：探讨重症高血压脑出血术后患者气管切开手术时机对预后的影响。方法：对重症高血压脑出血术后患者行气管切开术47例,按切开时机分为早切组25例（≤24 h）和非早切组22例（〉24 h）。比较2组患者1周后的格拉斯哥昏迷评分、肺部感染、低氧血症发生率及病死率。结果：早切组1周后的格拉斯哥昏迷评分高于非早切组（P〈0.05）,而肺部感染、低氧血症发生率及病死率均低于非早切组（P〈0.05-P〈0.01）。结论：重症高血压脑出血术后患者早期行气管切开能明显改善患者预后,降低患者病死率和肺部感染的发生率。Objective： To investigate the traeheotomy timing and its effects on prognosis in severe hypertensive intracerebral hemorrhage patients after operation. Methods：The patients with severe hypertensive intracerebral hemorrhage after operation（47 cases） were divided into the early cutting group（ less than or equal to 24 h,25 cases） and non-early cutting group （more than 24 h ,22 cases） according to the tracheotomy timing. The Glasgow coma score （ GCS）, pulmonary infection, incidence of bypoxemia and fatality rate between two groups were compared after 1 week of tracheotomy, Results ： After 1 week of tracheotomy, the GCS in the early cutting group was higher than that in non-early cutting group （P 〈 0.05 ） , and the pulmonary infection, incidence of hypoxemia and fatality rate in the early cutting group were lower than those in non-early cutting group（P 〈 0.05 to P 〈 0.01 ）. Conclusions：The early tracheotomy can significantly improve the prognosis, and reduce the fatality rate and incidence of pulmonary infection in postoperative patients with hypertensive cerebral hemorrhage.

关 键 词：脑出血 高血压 气管切开 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]