56例极重型乙脑患者应用人工呼吸器治疗的并发症和死亡原因分析

Complications and Death Cause Analysis of 56 Cases of Fatal Epidemic Encephalitis B Treated with Artificial Respirator

对 5 6例使用机械通气的极重型乙脑患者的并发症和死亡原因进行分析。 5 6例患者呼吸衰竭的原因为 :脑水肿、脑疝 1 0例 ,呼吸道分泌物阻塞 8例 ,呼吸肌瘫痪 8例 ,混合因素 3 0例。应用机械通气后 5 6例患者中出现并发症的有 5 0例 (89.3 % )。机械通气 1 0d内仅 4例 (7.1 4% )发生感染 ,机械通气大于 2 0d有 48例 (85 .7% )发生感染(P <0 .0 1 ) ;同时机械通气大于 2 0d患者绿脓杆菌感染高达 2 7例 (4 8.2 % ) ,而机械通气小于 2 0d者仅 2例 (3 .6% )绿脓杆菌感染 (P <0 .0 1 )。结果提示 :极重型乙脑患者使用机械通气极易发生感染等并发症 ,通气天数减少 ,则并发症减少 ,病人存活机会增加。

This study analysed complications and death cuases of 56 cases of fatal epidemic encephalitis B treated with artificial respirator. Average age was 19 years.50/56(89%) cases had complications . 48/56(85.7%)cases hadhospital infection.29 cases had bacillus aeruginosus infection. 8 cases had bacillus mucosus capsulatus infection.3 cases had fungus infection. One cases had bacillus coli infection.7 cases had other G + bacteria infection.During the ten days treated with mechanical ventinator 4/56(7.14%) cases had hospital infection. With the days of mechanical ventinator increased there were 48/56(85.7%) cases who had hospital infection. During 20 days with mechanical ventinator 2/56( 3.6 %) cases had bacillus aeruginosus infection. After 20 days with mechanical ventinator 27/56( 48.2 %) cases had bacillus aeruginosus infection( P < 0.01 ). 5 cases had pressure injure. 2 cases had hypodermal emphysema. 3 cases had mediastinum emphysema. 20 cases had hemorrhage of degestive tract. Conclusion :The duration of mechanical ventinator was the key to hospital infection. To decrease the time of mechanical ventinator may decrease infection and fatality rate.