重症颅脑外伤患者术后早期呼吸机辅助治疗对患者预后的疗效评价

Evaluation of the Effect of Early Postoperative Ventilator Adjuvant Therapy on the Prognosis of Patients with Severe Traumatic Brain Injury

目的分析重症颅脑外伤患者经手术治疗后早期辅以呼吸机治疗对患者预后效果的影响。方法该次研究时间范围为2017年1月—2020年4月,研究对象抽选该科收治罹患重症颅脑外伤患者76例,均接受手术治疗,随机将患者分为两组,对照组术后根据患者病情变化予以呼吸机治疗,观察组患者术后即进行早期呼吸机辅助治疗,分别检测对比两组患者治疗前后血气指标及神经功能变化情况,对两组患者进行为期3个月的随访,计算各组患者预后生存率及并发症发生率。结果两组患者治疗前血气指标、神经功能评分差异无统计学意义(P>0.05),治疗后,两组均有明显改善,观察组患者PaO2(97.02±5.13)mmHg明显高于对照组,PaCO2(40.44±1.96)mmHg低于对照组,差异有统计学意义(t=11.516、17.924,P<0.05);观察组患者GCS评分(12.02±1.11)分相较对照组较高,NIHSS评分(8.52±1.12)分较对照组较低,差异有统计学意义(t=14.464、15.953,P<0.05);观察组患者预后3个月生存率相较对照组高,并发症总发生率较低,与对照组相比差异有统计学意义(P<0.05)。结论重症颅脑外伤患者经手术治疗后应尽快接受早期呼吸机辅助治疗,能够改善患者血气分析指标,帮助神经功能恢复,减少并发症。

Objective To analyze the effect of early treatment with ventilator on the prognosis of patients with severe traumatic brain injury after surgery.Methods The study time range is from January 2017 to April 2020.The subjects selected the department to treat 76 patients suffering from severe traumatic brain injury,and all received surgical treatment.The patients were randomly divided into two groups.The control group was postoperatively patients in the observation group were treated with ventilator based on changes in their condition.Patients in the observation group were treated with early ventilator adjuvant therapy immediately after the operation.The blood gas indexes and neurological function changes of the two groups of patients before and after treatment were tested and compared.The two groups of patients were followed up for 3 months.Calculated the prognostic survival rate and complication rate of each group of patients.Results There was no statistically significant difference in blood gas indexes and neurological function scores between the two groups before treatment(P>0.05).After treatment,both groups were significantly improved.The observation group had a significantly higher PaO2(97.02±5.13)mmHg than the control group,and PaCO2(40.44±1.96)mmHg was lower than the control group,the difference was statistically significant(t=11.516,17.924,P<0.05);the observation group had a higher GCS score(12.02±1.11)points than the control group,and the NIHSS score(8.52±1.12)points were lower than those of the control group,and the difference was statistically significant(t=14.464,15.953,P<0.05);the observation group had a higher 3-month survival rate than the control group,and the overall incidence of complications was lower.Compared with the control group,the difference was statistically significant(P<0.05).Conclusion Patients with severe traumatic brain injury should receive early ventilator adjuvant treatment as soon as possible after surgical treatment,which can improve the blood gas analysis indexes of patients,help the recovery of nerve function,and reduce complications.It is worthy of application and promotion.