重症脑梗死合并肺感染患者早期气管切开术的临床疗效  

Clinical effect of early tracheotomy in patients with severe cerebral infarction combined with pulmonary infection

作　　者：林康越 廖晓荣 叶石生 肖玉梅[1] LIN Kang-yue;LIAO Xiao-rong;YE Shi-sheng;XIAO Yu-mei(Dpartment of Neuro-intensive Care Unit,Maoming People′s Hospital,Guangdong Province,Maoming525000,China)

机构地区：[1]广东省茂名市人民医院神经重症监护室,广东茂名525000

出　　处：《中国当代医药》2021年第34期83-86,共4页China Modern Medicine

摘　　要：目的探讨急性重症脑梗死合并肺部感染患者早期行气管切开术的临床疗效。方法回顾性分析2017年1月至2020年7月茂名市人民医院重症监护室(ICU)收治的78例急性重症脑梗死早期合并肺部感染患者的临床资料。根据入院后行气管切开术时间不同的患者分为早期气切组(36例)和晚期气切组(42例)。比较两组的机械通气时长、住ICU时长、总住院时长、抗生素使用时长、联合抗生素使用率,以及并发症发生率、ICU病死率、住院总病死率。结果两组的气管切开术总并发症发生率、ICU病死率及住院总病死率比较,差异无统计学意义(P>0.05);早期气切组在机械通气时长、住ICU时长、总住院时长、抗生素使用时长、联合抗生素使用率及严重并发症总发生率均低于晚期气切组患者,差异有统计学意义(P<0.05)。结论早期气管切开有利于降低重症脑梗死早期合并肺感染患者的严重并发症总发生率及联合抗生素使用率,并缩短机械通气时长、抗生素使用时长、住ICU时长以及总住院时长,在临床中值得推广应用。Objective To explore the clinical effect of early tracheotomy in patients with severe cerebral infarction combined with pulmonary infection.Methods The clinical data of 78 patients with early acute severe cerebral infarction complicated with pulmonary infection in the intensive care unit(ICU)of Maoming People′s Hospital from January 2017 to July 2020 was retrospectively analyzed.According to the time of tracheotomy after admission,patients were divided into an early tracheotomy group with 36 cases and a late tracheotomy group with 42 cases.The duration of mechanical ventilation,stay in ICU,total hospital stay,duration of antibiotic use,combined antibiotic use rate,complication rate,ICU mortality rate,and total hospital fatality rate were compared between the two groups.Results There was no significant difference in the total complication rate of tracheotomy,ICU mortality rate,or total hospital fatality rate between the two groups(P>0.05).The duration of mechanical ventilation,stay in ICU,total hospital stay,duration of antibiotic use,combined antibiotic use rate and total incidence of serious complications in the early tracheotomy group were lower than those in the late tracheostomy group,and the differences were statistically significant(P<0.05).Conclusion Early tracheotomy is beneficial to decrease the total incidence of serious complications and the use of combined antibiotics in patients with early severe cerebral infarction combined with pulmonary infection,and shorten mechanical ventilation,and reduce antibiotic use,stay in ICU,and total hospital stay.It is worthy of promotion and application in clinical practice.

关 键 词：重症缺血性脑卒中 肺部感染 早期气管切开术 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]