气管切开术治疗重症脑外伤的临床治疗研究

Clinical Study of Tracheotomy for Severe Traumatic Brain Injury

目的探讨气管切开术治疗重症脑外伤的临床治疗研究。方法将2014年12月—2019年12月在我院神经外科及ICU治疗的100例重症脑外伤患者随机分为两组,对照组采用传统气管切开术,观察组采用经皮扩张气管切开术,对比两组的手术各指标、并发症发生率、术后恢复指标。结果观察组手术时间、切口长度、术中出血量均少于对照组(P <0.05);观察组术后切口出血、切口感染、皮下气肿、气胸、食管损伤等并发症发生率低于对照组(P <0.05),两组肺部感染率、死亡率差异无统计学意义(P> 0.05);观察组呼吸机使用时间、带管时间、住院时间、切口愈合时间短于对照组(P <0.05)。结论气管切开术治疗重症脑外伤的临床疗效显著,创伤小,并发症发生率低,有助于患者早期恢复自主呼吸功能,加快康复速度。

Objective To investigate the clinical treatment of severe traumatic brain injury by tracheotomy.Methods 100 patients with severe brain injury who were treated in the ICU of our hospital from December 2014 to December 2019 were randomly divided into two groups.The control group was treated with traditional tracheotomy,and the observation group was treated with percutaneous dilated tracheotomy.Results The operation time,incision length and intraoperative blood loss in the observation group were less than those in the control group(P<0.05).The incidence of postoperative incision bleeding,incision infection,subcutaneous emphysema,pneumothorax,esophageal injury and other complications in the observation group was significantly lower than that in the control group(P<0.05).The duration of ventilator use,duration of catheter application,duration of hospitalization,and duration of incision healing in the observation group were significantly shorter than those in the control group(P<0.05).Conclusion Tracheotomy has a significant clinical effect in the treatment of severe traumatic brain injury,with small trauma and low incidence of complications.It is helpful for patients to recover the function of spontaneous breathing in the early stage and speed up the recovery.