气管切开时机对重症高血压脑出血术后患者自理能力和预后的影响  

Effects of timing of tracheotomy on self-care ability and prognosis of patients after severe hypertensive cerebral hemorrhage

作　　者：梁才干 覃华强[1] 阮响 LIANG Caigan;TAN Huaqiang;RUAN Xiang(Department of Neurosurgery of Huaiji County People’s Hospital,Zhaoqing 526400Guangdong,China)

机构地区：[1]肇庆市怀集县人民医院神经外科,广东肇庆526400

出　　处：《中国民康医学》2020年第17期116-117,120,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨气管切开时机对重症高血压脑出血术后患者自理能力和预后的影响。方法:按气管切开时机不同将80例重症高血压脑出血术后患者分为对照组和观察组各40例,对照组于术后24 h后行气管切开,观察组于术后24 h内行气管切开。比较两组日常生活能力(ADL)分级、并发症发生率、气管套管留置时间、住院时间和格拉斯哥昏迷指数(GCS)评分。结果:治疗后,观察组ADL分级中Ⅰ级、Ⅱ级占比均高于对照组,差异有统计学意义(P<0.05);观察组肺部感染发生率为35.00%、低氧血症发生率为7.50%、再出血发生率为15.00%,分别低于对照组的72.50%、35.00%、35.00%,差异有统计学意义(P<0.05);观察组气管套管留置时间和住院时间均明显短于对照组,差异有统计学意义(P<0.05);治疗后,观察组GCS评分高于对照组,差异有统计学意义(P<0.05)。结论:重症高血压脑出血患者术后24 h内行气管切开可提高其日常生活能力和GCS评分,降低并发症发生率,缩短气管套管留置时间和住院时间,其效果优于术后24 h后行气管切开效果。Objective:To investigate effects of timing of tracheotomy on self-care ability and prognosis of patients after severe hypertensive cerebral hemorrhage.Methods:According to the timing of tracheotomy,80 patients with severe hypertensive intracerebral hemorrhage were divided into control group and observation group,each with 40 cases.The control group underwent tracheotomy 24 hours after the operation,while the observation group underwent tracheotomy within 24 hours after the operation.The level of daily living ability classification,complication rate,postoperative index level and Glasgow coma index(GCS)score were compared between the two groups.Results:After the treatment,the proportions of Grade I and Grade II in the ADL classification of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of pulmonary infection in the observation group was 35.00%,the incidence of hypoxemia was 7.50%,and the incidence of rebleeding was 15.00%,which were all lower than the control group of 72.50%,35.00%,and 35.00%,respectively,and the differences were statistically significant.(P<0.05).The tracheal cannula indwelling time and hospital stay in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).Before the treatment,there was no significant difference in the GCS scores between the two groups(P>0.05).However,after the treatment,the GCS score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusions:For the patients with severe hypertensive intracerebral hemorrhage,the implementation of tracheotomy within 24 hours after operation can improve their ability of daily living and GCS score,reduce the incidence of complications,and shorten the tracheal cannula indwelling time and hospital stay.Moreover,it is superior to tracheotomy 24 hours after operation.

关 键 词：重症 高血压脑出血 术后 气管切开时机 自理能力 

分 类 号：R473.5[医药卫生—护理学]