呼吸回路连接装置行高压氧治疗重型颅脑损伤气管切开患者对控制感染的作用  

Effect of hyperbaric oxygen therapy on brain infection in patients with severe traumatic brain injury treated by breathing circuit connection device

作　　者：芮奕峰[1] 郁慧杰[2] 唐玉明[1] 

机构地区：[1]嘉兴市第一医院神经外科,浙江嘉兴314050 [2]嘉兴市第一医院急诊监护科,浙江嘉兴314050

出　　处：《中华医院感染学杂志》2016年第24期5632-5634,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划项目(2014KYB270)

摘　　要：目的探讨重型颅脑损伤气管切开患者于治疗期间使用呼吸回路对控制感染的作用,为临床治疗提供参考依据。方法回顾性分析医院2014年6月-2016年3月75例重型颅脑损伤气管切开后脱离呼吸机肺部感染患者临床资料,呼吸回路连接装置行高压氧治疗者为观察组40例;于常压下实施吸氧管氧疗者为对照组35例;比较两组患者感染下降情况及气管套管拔除情况。结果观察组感染控制率62.5%,明显高于对照组34.3%;观察组体温恢复正常时间、呼吸音清晰时间和咳嗽、咳痰好转时间及白细胞、粒细胞比率恢复正常时间均明显短于对照组;观察组于治疗第2周、4周及气管切开后2个月气管套管拔除率明显高于对照组,两组比较差异均有统计学意义(P<0.05)。结论呼吸回路连接装置行高压氧治疗可有效控制重型颅脑损伤气管切开患者的感染情况,有利于促进患者康复。OBJECTIVE To investigate the severe brain injury in patients with tracheotomy breathing circuit during treatment to control infection.To investigate the effect of breathing circuit on the control of infection during tracheotomy in patients with severe brain injury,so as to provide references for clinical treatment.METHODS Clinical data of 75 patients with severe brain injury after trachea incision without breathing device in our hospital from Jun.2014 to Mar.2016 were retrospectively analyzed,including observation group with 40 cases of patients with hyperbaric oxygen treatment by breathing circuit connection device,and control group with 35 cases of patients with oxygen tube oxygen therapy at normal pressure.The reduction of infection and tracheal extubation were compared between the two groups.RESULTS The infection control rate of observation group was 62.5%,which was significantly higher than 34.3% of control group.The body temperature returned to normal time,breath sounds clear time,cough and expectoration improvement time and the ratio of leukocyte and neutrophil returned to normal time of observation group were significantly shorter than those of control group.The tracheal extubation rates after 2weeks and 4weeks of treatment and 2 months after tracheotomy were significantly higher in observation group than those in the control group（P〈0.05）.CONCLUSION Hyperbaric oxygen therapy by breathing circuit connection device can effectively control the infection in patients with severe brain injury with tracheotomy,and promote the rehabilitation of patients.

关 键 词：呼吸回路连接装置 高压氧 重型颅脑损伤 气管切开 感染 

分 类 号：R651.1[医药卫生—外科学]