不同气管切开时机对高龄机械通气危重患者预后效果的影响  

Effect of different tracheotomy timing on prognostic effect of elderly critical ill patients with mechanical ventilation

作　　者：廖梅嫣 黄滔 朝勇 吴海宾[1] 曾汇霞 LIAO Mei-yan;HUANG Tao;CHAO Yong(Zhaoqing Second People’s Hospital, Zhaoqing 526060, China)

机构地区：[1]广东省肇庆市第二人民医院

出　　处：《中国现代药物应用》2019年第18期10-11,共2页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨不同气管切开时机对高龄机械通气危重患者预后的影响。方法 105例高龄机械通气重症加强护理病房(ICU)危重患者,按照气管切开术前气管插管时间不同分为对照组(气管切开术前气管插管时间>7d,47例)和研究组(气管切开术前气管插管时间≤7d,58例)。对比两组气管切开后通气时间、ICU监护时间、感染及死亡情况。结果 研究组气管切开后通气时间、ICU监护时间分别为(18.76±4.05)、(15.04±5.56)d,均短于对照组的(25.93±5.12)、(19.42±6.23)d,差异均具有统计学意义(P<0.05)。研究组感染率、1个月内死亡率、院内死亡率、1年死亡率分别为20.69%、27.59%、48.28%、60.34%,与对照组的29.79%、38.30%、57.45%、68.09%比较差异均无统计学意义(P>0.05)。结论 早期气管切开可以缩短高龄机械通气危重患者ICU监护时间、通气时间,但不能改善患者预后。Objective To discuss the effect of different tracheotomy timing on prognostic effect of elderly critical ill patients with mechanical ventilation. Methods A total of 105 elderly critical ill patients with mechanical ventilation in intensive care unit (ICU) were divided by different duration of tracheal intubation before tracheotomy into control group (duration of tracheal intubation before tracheotomy>7 d, 47 cases) and research group (duration of tracheal intubation before tracheotomy≤7 d, 58 cases). Comparison was made on ventilation time, ICU monitoring time after tracheotomy, infection and mortality status between the two groups. Results After tracheotomy, the research group had shorter ventilation time and ICU monitoring time respectively as (18.76±4.05) and (15.04±5.56) d than (25.93±5.12) and (19.42±6.23) d in the control group. Their difference was statistically significant (P<0.05). The research group had no statistically significant difference in infection rate, mortality rate within 1 month, in-hospital mortality rate and mortality rate within 1 year respectively as 20.69%, 27.59%, 48.28% and 60.34%, compared with 29.79%, 38.30%, 57.45% and 68.09% in the control group (P>0.05). Conclusion Early tracheotomy can shorten ICU monitoring time and ventilation time of elderly critically ill patients with mechanical ventilation, but it can not improve their prognosis.

关 键 词：高龄危重患者 气管切开术 机械通气 预后 

分 类 号：R459.7[医药卫生—急诊医学]