早期经皮气管切开对重型颅脑外伤患者肺部感染和预后的影响  

Effect of Early Percutaneous Tracheotomy on Pulmonary Infection and Prognosis in Patients with Severe Traumatic Brain Injury

作　　者：庄严[1] 刘介平[1] 谢正兴[1] 蒋明[1] ZHUANG Yan;LIU Jieping;XIE Zhengxing;JIANG Ming(不详;Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院,江苏镇江212001

出　　处：《中外医学研究》2022年第33期122-125,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究早期经皮气管切开对重型颅脑外伤(sTBI)患者肺部感染和预后效果的影响。方法:选择2011年1月-2021年1月江苏大学附属医院神经外科收治的102例sTBI患者作为研究对象,根据经皮气管切开术时间分为试验组(损伤24 h内,n=51)与对照组(损伤24 h后,n=51)。两组均接受经皮气管切开治疗,试验组治疗时间为损伤24 h内,对照组治疗时间为损伤24 h后。比较两组肺部感染发生率、炎症因子指标及预后。结果:试验组肺部感染率低于对照组,差异有统计学意义(P<0.05);试验组术后7 d降钙素原(PCT)、白细胞计数(WBC)、中性粒细胞百分比均低于对照组,差异均有统计学意义(P<0.05);试验组肌松剂使用率低于对照组,重症监护室(ICU)入住时间、整体住院时间均短于对照组,出院时格拉斯哥预后评分(GOS)评分高于对照组,差异均有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:早期经皮气管切开治疗能有效降低sTBI患者肺部感染发生率,对减轻患者体内炎症反应、缩短住院时间、提高预后效果均有积极作用,值得深入研究。Objective:To study the effect of early percutaneous tracheotomy on pulmonary infection and prognosis in patients with severe craniocerebral injury(sTBI).Method:A total of 102 patients with STBI who admitted to the Department of Neurosurgery of the Affiliated Hospital of Jiangsu University from January 2011 to January 2021 were selected as the study objects,and according to the time of percutaneous tracheotomy,they were divided into the experimental group(within 24 h of injury,n=51)and the control group(after 24 h of injury,n=51).Two groups were given percutaneous tracheotomy,the treatment time of the experimental group was within 24 h after injury,and the treatment time of the control group was 24 h after injury.The incidence of pulmonary infection,inflammatory factors and prognosis were compared between two groups.Result:The incidence of pulmonary infection of the experimental group was lower than that of the control group,the difference was statistically significant(P<0.05).The procalcitonin(PCT),white blood cell count(WBC)and percentage of neutrophils in the experimental group at 7 d after operation were lower than those in the control group,the differences were statistically significant(P<0.05);the use rate of muscle relaxant in the experimental group was lower than that in the control group,the time of admission in the intensive care unit(ICU)and the overall length of stay were shorter than those in the control group,Glasgow outcome score(GOS)at discharge was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications after operation between two groups(P>0.05).Conclusion:Early percutaneous tracheotomy can effectively reduce the incidence of pulmonary infection in patients with STBI,and has a positive effect on reducing the inflammatory reaction,shortening the hospitalization time and improving the prognosis,it is worthy of further study.

关 键 词：重型颅脑外伤 经皮气管切开 早期 肺部感染 预后效果 

分 类 号：R651.15[医药卫生—外科学]