早期气管切开在颅脑外伤与脑出血患者救治中的应用价值

Application Value of Early Tracheotomy in the Treatment of Patients with Craniocerebral Trauma and Cerebral Hemorrhage

目的 研究早期气管切开术对颅脑外伤及脑出血患者的救治效果及其安全性。方法 选取2018年7月—2020年7月期间该院收治的100例颅脑外伤和脑出血患者为研究对象,按照随机数表法分为观察组和对照组,各50例。对照组患者通过常规脑外伤脑出血疗法进行治疗,观察组患者通过早期气管切开术进行治疗。比较两组患者的临床治疗总有效率、术后并发症发生率、术前术后的生活质量评分、术后不同时间的血肿量和术后不同时间的NIHSS评分。结果 观察组患者的临床治疗总有效率(96.0%)高于对照组(76.0%),差异有统计学意义(χ^(2)=8.306,P<0.05);观察组患者的并发症发生率低于对照组,差异有统计学意义(P<0.05);术后,观察组患者的各项生活质量评分均高于对照组患者,差异有统计学意义(P<0.05);观察组患者和对照组患者治疗后24 h的血肿量对比,差异无统计学意义(P>0.05),观察组患者治疗后7 d、治疗后14 d的血肿量低于对照组患者,差异有统计学意义(P<0.05);观察组患者和对照组患者治疗后24 h的NIHSS对比,差异无统计学意义(P>0.05),观察组患者治疗后7 d、治疗后14 d的NIHSS低于对照组患者,差异有统计学意义(P<0.05)。结论 颅脑外伤和脑出血患者通过早期气管切开术进行治疗,能够有效提升临床疗效,并发症发生率低,生活质量、血肿量及神经功能均得到明显改善,应用价值高。

Objective To study the efficacy and safety of early tracheotomy in patients with craniocerebral trauma and cerebral hemorrhage.MethodsSelected 100 patients with craniocerebral trauma and cerebral hemorrhage who were treated in the hospital from July 2018 to July 2020 as the research objects,and they were divided into an observation group and a control group according to the random number table method,with 50 cases in each group.The patients in the control group were treated with conventional cerebral hemorrhage therapy for traumatic brain injury,and the patients in the observation group were treated with early tracheotomy.The total effective rate of clinical treatment,incidence of postoperative complications,preoperative and postoperative quality of life scores,postoperative hematoma volume at different times and NIHSS scores at different postoperative times were compared between the two groups.ResultsThe total effective rate of clinical treatment in the observation group was 96.0% higher than that in the control group(76.0%),and the difference was statistically significant(χ^(2)=8.306,P0.05).The hematoma volume of the observation group was lower than that of the control group at 7 d and 14 d after treatment,and the difference was statistically significant(P0.05).The NIHSS of the observation group was lower than that of the control group at 7 d and 14 d after treatment,and the difference was statistically significant(P<0.05).ConclusionEarly tracheotomy for the treatment of patients with craniocerebral trauma and cerebral hemorrhage can effectively improve the clinical efficacy,reduce the incidence of complications,and significantly improve the quality of life,hematoma volume and neurological function.It has high application value.