重度出血性脑血管病早期经皮气管切开效果的研究

Effects of early percutaneous tracheotomy on critical hemorrhagic cerebrovascular diseases

目的 分析重度出血性脑血管病早期经皮气管切开的效果.方法 回顾性分析本院ICU 2008年1月～2012年1月收治的重度出血性脑血管病患者58例,根据气管切开时间分为早期组30例、晚期组28例;比较两组术后并发症发生率、病死率、机械通气时间、入住ICU时间.结果 早期组较晚期组肺部感染发生率明显降低,而两组其他并发症以及病死率差异无统计学意义（P＞0.05）；早期组机械通气时间、入住ICU时间较晚期组明显缩短,差异有统计学意义（P＜0.05）.结论 早期经皮气管切开可显著降低重度出血性脑血管病患者机械通气时间,缩短入住ICU的时间,降低肺部感染发生率.

Objective To analyze the effects of early percutaneous tracheotomy on critical hemorrhagic cerebrovascular diseases （HCVD）. Methods 58 patients with critical HCVD admitted into intensive care unit （ICU） in our hospital from January 2008 to January 2012 were retrospectively analyzed. Based on time to perform tracheotomy, they were divided into early stage group （n=30） and late stage group （n=28）. The incidence of complications, mortality rate, mechanical ventilation time, and ICU stay were compared after surgeries in both groups. Results In the early stage group, the inci- dence of pulmonary infection was much lower than that of the late stage group, but there was no significant difference in occurrence of other complications or mortality rate （P〉0.05）. The mechanical ventilation time and ICU stay in the early stage group were greatly shorter than those in the late stage group with statistical differences （P〈0.05）. Conclu- sion Early percutaneous tracheotomy can remarkably shorten the mechanical ventilation time and ICU stay of critical HCVD patients as well as reduce incidence of pulmonary infection.