气管切开术对老年多脏器衰竭患者抢救效率及预后的影响

Effect of Tracheotomy on Rescue Efficiency and Prognosis of Elderly Patients with Multiple Organ Failure

目的:研究气管切开术对老年多脏器衰竭患者抢救效率及预后的影响。方法:选取本院2015年2月-2017年5月收治的老年多脏器衰竭并行抢救的患者70例作为研究对象,按其是否使用气管切开术分为对照组(n=35)和观察组(n=35)。对照组不进行气管切开术,观察组在抢救过程中使用气管切开术,比较两组抢救有效情况、治疗前后的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)和快速序贯器官衰竭(qSOFA)评分以及家属满意度情况。结果:观察组抢救有效率为68.57%明显高于对照组的42.86%,差异有统计学意义(χ~2=4.690,P=0.030)。治疗前两组APACHEⅡ及qSOFA评分比较,差异均无统计学意义(P>0.05);治疗后,观察组APACHEⅡ及qSOFA评分均明显低于对照组,差异均有统计学意义(P<0.05)。观察组家属满意度明显高于对照组,差异有统计学意义(χ~2=4.768,P=0.029)。结论:对老年多脏器衰竭患者抢救过程中进行气管切开术能有效提高抢救有效率,改善患者预后,值得临床推广。

ObjectiveTo study the effect of tracheotomy on the rescue efficiency and prognosis of elderly patients with multiple organ failure.Method：A total of 70 elderly patients with multiple organ failures treated in our hospital from February 2015 to May 2017 were selected as the study objects.According to whether tracheotomy was used,they were divided into control group （n=35） and observation group （n=35）.The control group was not used tracheotomy,the observation group was used tracheotomy during the rescue process.The rescue effectiveness, acute physiology and chronic health status score system Ⅱ（APACHEⅡ） and rapid sequential organ failure （qSOFA） scores before and after treatment and family satisfaction between the two groups were compared. Result：The effective rate of the observation group was 68.57%,which was significantly higher than 42.86% of the control group,the difference was statistically significant （ χ2=4.690,P=0.030）.There were no significant differences in APACHEⅡ and qSOFA scores between the two groups before treatment （P〉0.05）;after treatment,the APACHEⅡ and qSOFA scores in the observation group were significantly lower than those in the control group,the differences were statistically significant （P〈0.05）.The family satisfaction of the observation group was significantly higher than that of the control group,the difference was statistically significant （ χ2=4.768,P=0.029）.Conclusion： Tracheotomy for elderly patients with multiple organ failure during the rescue process can effectively improve the rescue efficiency and the prognosis of patients, which is worthy of clinical promotion.