早期气管切开治疗重型颅脑外伤的临床疗效分析  

Analysis of curative effect on earlytracheotomy treatment of severetraumatic brain injury

作　　者：刘飞皎[1] 孙含蓄[1] 孙世远[1] 

机构地区：[1]河南省南阳市第一人民医院神经外科,河南南阳473000

出　　处：《中国伤残医学》2017年第8期22-24,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：观察早期气管切开治疗重型颅脑外伤临床有效性.方法：选取南阳市第一人民医院2013年10月-2015年12月收治的83例受伤后6小时内急诊入院的重型颅脑外伤病人,按照颅脑外伤格拉斯哥昏迷评分分级,均符合重型颅脑外伤诊断标准,随机分为A对照组（40例）、B早期气管切开组（43例）.A组按照颅脑创伤临床救治指南采用手术或非手术治疗,维持生命体征稳定、降颅压、控制肺部感染、营养支持及应用神经营养药物综合治疗,必要时行气管切开,切开的时机选择在伤后48小时后;B组在对照组治疗的基础上早期（24小时内）行气管切开.比较2组病人的死亡率、3个月后的格拉斯哥预后评分（GOS）和肺部感染情况.计数资料均以 x±s 表示,计量资料采用t 检验,p〈0.05 认定为差异有统计学意义.结果：（1）死亡率B组低于A组（p〈0.05）.（2）治疗后3个月GOS评分：B组明显高于A组（p〈0.05）.（3）A、B2组病人的肺部感染率无统计学差异.结论：（1）早期气管切开能明显降低重型颅脑外伤病人的死亡率,提高病人的GOS评分,改善预后.（2）早期气管切开不会增加重型颅脑外伤病人的肺部感染率.Objective：To investigate the efficacy of Early Tracheotomy in the treatment of Severe Traumatic Brain Injury.Methods：We divided the 83 Severe Traumatic Brain Injury patients,who were taken into the Neurosurgery Department of our hospital in 6 hours of their emergency from October 2013 to December 2015,into 2 groups at random：Group A as control （40 cases）;Group B were treated with Early Tracheotomy （43 cases）.Group A are treated with non-operation or operation under the direction of clinical guidance for Severe Traumatic Brain Injury.The specific measures include to keep the vital signs,reduce intracranial hypertension,control lung infection,nutrition support and synthetic treatment with nerve nutrition medicine,take Tracheotomy in 48 hours of the emergency if necessary.Group B is based on Group A with Early Tracheotomy.Comparing the 2 groups on Mortality,3 months after treatment GOS score and rate of lung infection.Measurement data expressed by（ ±s）,q test the mean and analyse the variance,count data tested by X2,take α =0.05 as significant level.Results：1.Mortality：Group B was lower than Group A（p〈0.05）.2.GOS score After treatment（after 3 months）：Group B was significantly higher than Group A（p〈0.05）.3.The rate of lung infection had no statistically significant difference between the two groups.Conclusion：1、Early Tracheotomy could significantly reduce the Mortality and Improve the GOS scores of the patients with Severe Traumatic Brain Injury,improve the prognosis.2、Early Tracheotomy didn＇t Improve The rate of lung infection in patients with Severe Traumatic Brain Injury.

关 键 词：早期气管切开 重型颅脑外伤 疗效 

分 类 号：R651.1[医药卫生—外科学]