颅脑外伤术后昏迷患者持续使用呼吸机的临床效果  

Clinical effect of continuous use of ventilator in coma patients after craniocerebral injury

作　　者：翁中海 余爱华 潘长福 WENG Zhonghai;YU Aihua;PAN Changfu(Department of Traumatologic Brain Surgery,the First People's Hospital of Jingdezhen,Jingdezhen,Jiangxi 333000,China)

机构地区：[1]景德镇市第一人民医院创伤脑外科,江西景德镇333000

出　　处：《医药前沿》2024年第26期1-3,共3页Journal of Frontiers of Medicine

基　　金：景德镇市科技局项目(20221SFZC013)。

摘　　要：目的:观察颅脑外伤术后昏迷患者持续使用呼吸机的临床效果。方法:选取2020年1月—2023年4月景德镇市第一人民医院收治的颅脑外伤行去骨瓣减压术后仍昏迷患者68例,按治疗方式的不同分为观察组与对照组,每组34例。观察组术后持续使用呼吸机;对照组术后恢复自主呼吸后,血氧饱和度>95%,呼吸频率10~28次/min,动脉血氧分压>60mmHg即停用呼吸机带管呼吸。比较两组术后48h及停机1h颅内压,术后24、120h血清白蛋白,以及术后7d胸部CT检查肺部感染及气管内导管堵塞情况。结果:观察组术后48h及停机1h颅内压低于对照组,术后120h血清白蛋白高于对照组,差异具有统计学意义(P<0.05)。术后7d,两组胸部CT肺部感染发生率比较,差异无统计学意义(P>0.05);观察组气管内导管堵塞率低于对照组,差异具有统计学意义(P<0.05)。结论:颅脑外伤术后昏迷患者持续使用呼吸机能降低颅内压,减少血清白蛋白消耗及气管内导管堵塞发生,且未明显增加肺部感染发生率。Objective To observe the clinical effect of continuous use of ventilator in coma patients after craniocerebral injury.Methods A total of 68 patients with craniocerebral trauma who were still comatose after decompressectomy were selected from the First People's Hospital of Jingdezhen from January 2020 to April 2023,and were divided into observation group and control group according to the difference in treatment methods,with 34 cases in each group.Observation group continued to use the ventilator after surgery.After the control group resumed spontaneous respiration after surgery,the blood oxygen saturation was>95%,the respiratory rate was 10-28 times/min,and the arterial blood oxygen partial pressure was>60 mmHg.The intracranial pressure,serum albumin at 24 and 120 h after operation and chest CT at 7 days after operation were compared between the two groups for pulmonary infection and endotracheal catheter blockage.Results The intracranial pressure in the observation group was lower than that in the control group 48 h after operation and 1 h after shutdown,and the serum albumin in the observation group was higher than that in the control group 120 h after operation,the difference was statistically significant(P<0.05).Seven days after surgery,there was no significant difference in the incidence of chest CT pulmonary infection between the two groups(P>0.05);the plugging rate of intratracheal catheter in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusions Continuous use of respiratory function in comatose patients after craniocerebral trauma reduced intracranial pressure,serum albumin consumption and intratracheal catheter blockage,and did not significantly increase the incidence of pulmonary infection.

关 键 词：颅脑外伤 术后昏迷 持续使用呼吸机 

分 类 号：R742[医药卫生—神经病学与精神病学]