早期开放人工气道对重症脑卒中患者临床疗效及预后的影响

Influence of early opening artificial airway on clinical effect and prognosis in patients with severe stroke

目的探讨早期开放人工气道对重症脑卒中患者治疗效果及其神经功能恢复、生活质量的影响。方法选取2014年6月至2015年6月璧山区人民医院重症医学科诊治的76例重症脑卒中患者为研究对象,根据开放人工气道的时间不同分为观察组和对照组,每组各38例。比较两组患者治疗前后血气分析指标水平变化、神经功能缺损程度评分(NDS)及生活质量评分(MBI)。结果两组患者治疗后的Pa O2较治疗前升高,患者Pa CO2和心率则较治疗前呈不同程度的降低,且观察组较对照组明显,差异有统计学意义(P<0.05)。两组患者治疗后的NDS评分较治疗前呈不同程度的减少,MBI和功能综合评定量表(FCA)评分则较治疗前不同程度的增加,且观察组较对照组明显,差异有统计学意义(P<0.05);两组患者治疗后角色功能、心理功能、躯体功能及社会功能的评分均较治疗前增加,且观察组较对照组明显,差异具有统计学意义(P<0.05)。结论早期开放重症脑卒中患者人工气道能有效改善低氧血症,降低脑损伤程度,有利于患者神经功能的恢复,可有效提高患者的生活质量。

Objective To investigate the influyence of early opening artificial airway on the curative effect, neural functional recovery and living quality. Methods A total of 76 cases of severe stroke in the intensive care medicine department of our hospital from June 2014 to June 2015 were selected as the research subjects and divided into the observation group and control group based on the time of opening artificial airway, 38 eases in each group. The levels of blood gas analysis, neurological impair ment scores （NDS） and quality of life （MBI） scores before treatment and after treatment were compared between the two groups. Results PaO2 after treatment in the two groups was increased, while PaCO2 and heart rate after treatment were both decreased to different degrees, but the observation was more obvious than the control group, the difference was statistically significant （P〈0.05）. The NDS scores after treatment in the two groups were decreased to different degrees,while the MBI and FCA scores after treat- ment were increased to different degrees compared with before treatment, but the observation was more obvious than the control group, the difference was statistically different （P〈0.05）. The scores of role funetion, psyehological function, physical function and social function after treatment in the two groups were all increased,while the observer group was more obvious than the control group with statistical difference（P〈0.05）. Conclusion The early opening artificial airway in the patients with severe stroke can effectively improve hypoxemia, reduces the degree of brain damage, is conducive to the recovery of neurological function, and can effeetively improve the quality of life of patients.