重型颅脑损伤早期气管切开的临床意义

Clinical significance of early tracheotomy for severe craniocerebral injury

目的：探讨早期气管切开在降低重型颅脑损伤患者病死率中的作用。方法：2005年2月～2009年2月，我院共收治90例重型颅脑损伤患者。根据受伤到气管切开的时间分两组，A组47例：伤后12h内行气管切开术；B组43例：伤后12h后行气管切开术。结果：A组治愈25人，中残11人，重残5人，死亡6人，病死率为12．7％；B组治愈16人，中残10人，重残7人，死亡10人，病死率为23．2％。结论：早期气管切开术是抢救重症颅脑损伤的重要环节，保持呼吸道通畅可明显降低重型颅脑损伤患者的病死率，提高其治愈率及生存率。

Objective：To evaluate the significance of early tracheotomy in patients with severe craniocerebral injury for reducing the fatality rate. Methods ： Between Feb. 2005 ancl Feb. 2009, a total of 90 patients with severe craniocerebral trauma were admitted to our hospital, and those patients were allocated to two groups. Group A（ n = 47 ） received tracheotomy in 12 hours and the procedure was performed over 12 hours in group B （ n = 43 ） after the event. Results ： Twenty-five patients were cured in group A except for moderate disability in 11, severely disabled in 5 and death in 6. The case fatality rate was 12.7%. In group B, 16 patients were cured, and yet, 10 were moderately disabled, 7, critically disabled and 10,dead, which led to the mortality of 23.2%. Conclusion：Early traeheotomy is an important life-saving intervention for patients with severe craniocerebral injury, for it can keep the patient＇s respiratory tract unobstructed, thus leading to both recovery and survival rates.