重症超声在重型颅脑损伤术后患者呼吸管理中的应用价值

Application value of severe ultrasound in respiratory management of post-operatove patients with severe craniocerebral injury

目的探讨重症超声在重型颅脑损伤术后患者呼吸管理中的应用价值。方法选择2019年至2021年天津市武清区中医医院重症监护病房(ICU)收治的重型颅脑损伤开颅术后患者91例作为研究对象,随机分为常规诊疗组(48例)和重症超声组(43例)。比较两组患者的心肺疾病检出情况以及呼吸衰竭和肺部感染发生率、气管切开率、再次气管插管率、呼吸机支持时间、ICU住院时间。结果重症超声组患者术后即刻应用超声检查,心肺疾病即刻检出率为88.37%(38/43)。在ICU住院期间,重症超声组患者心肺疾病总检出率明显高于常规诊疗组[100.00%(43/43)比85.42%(41/48),P<0.05]。重症超声组患者呼吸衰竭和肺部感染发生率、气管切开率、再次气管插管率均明显低于常规诊疗组[呼吸衰竭:11.63%(5/43)比43.75%(21/48),肺部感染:11.63%(5143)比43.75%(21/48),气管切开:6.98%(3/43)比31.25%(15/48),再次气管插管:9.30%(4/43)比37.50%(18/48).均P<0.05].呼吸机支持时间较常规诊疗组明显延长(h:28.05±9.93比18.22±10.77.P<0.05)。两组患者的ICU住院时间比较差异无统计学意义(d:9.00±3.82比9.85±4.12.P>0.05)。结论重症超声应用于重型颅脑损伤术后患者能更早检出心肺疾病,提高心肺疾病检出率,实时监测、评估和指导治疗。虽然应用重症超声检查后呼吸机支持时间延长,但能够减少患者呼吸衰竭、肺部感染、气管切开及再次气管插管的发生。

Objective To explore the application value of ultrasound in rspiratory management of postoperative patients with severe craniocerebral injury.Methods Ninely-one patients with postoperative severe craniocerebral injury treated in the intensive care unit(ICU)of Tianjin W uqing Trarditional Chinese Medicine Hospital from 2019 to 2021 were enolled as the study objerts,and they were randomly divided into routine diagnosis and treatment group(48 cases)and severe patients ultrasound goup(43 cases).The detection of cardiopulmonary diseases,the incidences of respiratory failure and pulmonary infection,tracheolomy ralte,re-intubation rate.ventilator support time and ICU hospitalization time were compared between the 1wo groups.Results In the serverr patient ulrasound group,the patient after operation might immediately be sent to the ulrasound room to undergo examinaion,the deteetion rate of ceardiopulmonary disease being 88.37%(38/43).During ICU hospitalizaion.the tolal deetion rate of eardiopulmonary diseases in severe patient ultrasound group was signifieanly higher than that in routine diagnosis and treatment group[100.00%(43/43)vs.85.42%(41/48).P<0.05].The incidences of respiratory failure,pulmonary infertion,tracheotomy and re-intubation in severe patient ultrasound group were signifieantly lower than those in routine diagnosis and treatment group[respiratory failure:11.63%(5/43)vs.43.75%(21/48).pulmonary infection:11.63%(5/43)vs.43.75%(21/48).tracheotomy:6.98%(3/43)vs.31.25%(15/48),re-intubation:9.30%(4/43)vs.37.50%(18/48),all P<0.05].However,the support ime of ventilator was significantly higher than that of routine diagnosis and treatment group(hours:28.05±9.93 vs.18.22±10.77.P<0.05).There was no signifcant dfference in ICU length of stay between the two groups(days:9.00±3.82 vs.9.85±4.12.P>0.05).Conclusions The application of severe patient ultrasound in postoperative patients with severe craniocerebral injury can deteet cardiopulmonary diseases earlier,improve the detection rate of cardiopulmonary diseases,and monior,evaluate and guide treatment in real time.Although the venilator support time is longer in laking severe patient ulrasonography.it ean reduce the ineidences of respiratory failure,pulmonary infection,tracheotomy and re-endotracheal intubation.