早期经皮气管切开治疗原发性脑干出血的临床效果

A Clinical Study on the Efficacy of Early Percutaneous Tracheotomy in the Treatment of Primary Brain Stem Hemorrhage

目的:探讨早期经皮气管切开治疗原发性脑干出血中的临床效果。方法:选择2012年8月至2015年6月我院ICU收治的原发性脑干出血患者125例,按患者行气管切开的时间分组,以早期行气管切开(发病5 d内)定为观察组,发病5 d后行气管切开的患者定为对照组,对比两组患者的治疗效果。结果:两组患者的性别、年龄、APACHEII评分、GCS评分、疾病构成方面对比无明显差异(P>0.05);观察组患者气管切开时机为(2.6±0.8)d,低氧血症发生的次数(20.6±5.5)次,镇静药物用量(132.8±23.4)mg,抗生素使用时间(11.2±0.9)d,机械通气时间(153.5±82.4)h,HAP发生率44.6%,病死率23.1%,均明显优于对照组患者,差异具有统计学意义(P<0.05)。结论:早期气管切开有助于降低原发性脑干出血的死亡率,临床效果更好。

Objective： To investigate the efficacy of early percutaneous tracheotomy in the treatment of primary brain stem hemorrhage. Methods： From August 2012 to June 2015, 125 cases of patients with primary brain stem hemorrhage admitted in the ICU of our hospital and underwent tracheotomy of temporal were selected and randomly divided into the early tracheal incision（within 5 days after onset） as the observation group and 5 days after onset underwent tracheotomy as control group, the clinical sata were compared between two groups. Results： The tracheal incision time of observation group was（2.6±0.8） d, the number of hypoxemia was（20.6±5.5）, the sedative drug dosage was 13.28 ±23.4 mg, the use of antibiotics time was（11.2 ±0.9 d）, the duration of mechanical ventilation was（153.5 ＋ 8.24） h, the incidence rate of HAP was 44.6%, fatality rate was 23.1%, which were significantly better than those of the control group（P〈0.05）. Conclusions： Early tracheotomy was helpful to reduce the mortality of primary brain stem hemorrhage, and it was worthy of clinical application.