不同时间点气管切开对重症脑血管病患者治疗效果的影响  

Influence of Tracheotomy at Different Time Points on the Therapeutic Effect of Patients with Severe Cerebrovascular Disease

作　　者：王玉莉 胡红旗[1] 郭东才[1] 孙来广[1] 邢振义[1] WANG Yu-li;HU Hong-qi;GUO Dong-cai;SUN Lai-guang;XING Zhen-yi(Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院,河南新乡453000

出　　处：《现代诊断与治疗》2020年第20期3193-3195,共3页Modern Diagnosis and Treatment

摘　　要：目的探究不同时间点气管切开对重症脑血管病患者治疗效果的影响。方法选取2017年6月~2019年3月我院重症监护室收治住院的93例的重症脑血管病患者,以气管切开时间点划分为72h内切开组54例和≥72h切开组39例,对两组患者的疗效进行比较。结果72h内切开组ICU住院时间显著短于≥72h切开组,肺部感染率显著低于≥72h切开组,抗生素使用时间显著短于≥72h切开组,差异有统计学意义(P<0.05);72h内切开组总并发症发生率、心功能不全、肾功能不全及上消化道出血均低于≥72h切开组,差异有统计学意义(P<0.05)。72h内切开组机械通气人数显著少于≥72h切开组,通气时间显著低于≥72h切开组,差异有统计学意义(P<0.05)。结论72h内气管切开患者有更好的肺部管理、降低的临床并发症发生率,从而使重症脑血管病患者临床获益。Objective To investigate the influence of various tracheotomy time points on the treatment of patients with severe cerebrovascular disease.Methods From June 2017 to March 2019,clinical and general data from 93 patients with severe cerebrovascular disease who were hospitalized in our intensive care unitwere collected.According to the tracheotomy time point,they were divided into within 72h incision group(54 cases)and exceeding 72h incision group(39 cases).The efficacy of the two groups of patients was compared.Results ICU staying time in the incision group within 72h was lower than that in exceeding 72h incision group(P<0.05).The lung infection rate was significantly lower than that in the exceeding 72h incision group,and the using time of antibiotic was significantly shorter than that of the exceeding72h incision group,the difference was statistically significant(P<0.05);The total complication rate,cardiac insufficiency,renal insufficiencyand upper gastrointestinal bleeding in thewithin72h internal incision group were lower than those in the within72h internal incision group,the difference was statistically significant(P<0.05).The number of mechanically ventilated patients in the within72h internal incision group was significantly less than that of the exceeding 72h incision group,and the ventilation time was significantly lower than that of the exceeding 72h incision group.The difference was statistically significant(P<0.05).Conclusion Patients with tracheotomy within 72 hours had better lung management and lower clinical complications,which would benefit patients with severe cerebrovascular disease.

关 键 词：气管切开 重症脑血管病 

分 类 号：R743.3[医药卫生—神经病学与精神病学]