早期机械通气在高血压脑出血术后并发症防治中的作用  

Role of Early Mechanical Ventilation in the Prevention and Treatment of Postoperative Complications after Hypertensive Intracerebral Hemorrhage

作　　者：王恒福 万鹏飞 鲁健 王洪艳 WANG Hengfu;WAN Pengfei;LU Jian;WANG Hongyan(Xiuwen County People’s Hospital,Xiuwen 550200,China;不详)

机构地区：[1]修文县人民医院,贵州修文550200

出　　处：《中外医学研究》2022年第21期43-47,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究早期机械通气结合镇静镇痛在高血压脑出血围手术期控制并发症、改善患者预后中的作用。方法:对比性分析修文县人民医院2020年1-12月采取术后延迟麻醉复苏早期机械通气结合镇静镇痛治疗的45例高血压脑出血患者(观察组)和按相同标准收集的2018年1月-2019年12月采取术后立即常规麻醉复苏及治疗的72例患者(对照组),共117例高血压脑出血手术治疗患者的病历资料。结果:观察组低氧血症、收缩压≥180 mmHg、消化道出血、肺部感染、再出血发生率均低于对照组(P<0.05)。两组术前美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分比较,差异无统计学意义(P>0.05);观察组术后1周NIHSS评分低于对照组(P<0.05)。观察组术后1个月预后满意率(97.78%)高于对照组(83.33%)(P<0.05)。结论:以稳定呼吸循环功能为中心环节,为高血压脑出血术后患者原发性疾病的治疗和各种并发症的防治,提供一个稳定的内环境或条件,将机械通气在术后立即应用,作为预防性的治疗措施,对改善患者的预后是有益的。Objective:To study the role of early mechanical ventilation combined with sedation and analgesia in controlling the perioperative complications of hypertensive intracerebral hemorrhage and improving the patient prognosis.Method:The medical records of 117 patients with hypertensive intracerebral hemorrhage treated by surgery were analyzed,45 hypertensive intracerebral hemorrhage patients with delayed postoperative anesthesia and resuscitation and early mechanical ventilation combined with sedation and analgesia in Xiuwen County People’s Hospital from January to December 2020(the observation group),and 72 patients with immediate postoperative routine anesthesia and resuscitation and treatment collected according to the same standard from January 2018 to December 2019(the control group).Result:The incidences of hypoxemia,systolic blood pressure≥180 mmHg,gastrointestinal bleeding,pulmonary infection and rebleeding in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the preoperative NIHSS score between two groups(P>0.05);the NIHSS score of the observation group at 1 week after surgery was lower than that of the control group(P<0.05).The good prognosis rate in the observation group at 1 month after operation(97.78%)was higher than that in the control group(83.33%)(P<0.05).Conclusion:Taking stable respiratory circulation function,the center provides a stable internal environment or condition for the treatment of primary diseases and the treatment of various complications.The application of mechanical ventilation immediate postoperative as a preventive treatment measure is beneficial to improve the prognosis of patients.

关 键 词：高血压脑出血 早期机械通气 镇静镇痛 并发症 

分 类 号：R651.1[医药卫生—外科学]