早期经皮扩张气管切开术在重型颅脑损伤患者中的应用

目的探讨对重型颅脑损伤患者早期行经皮扩张气管切开术的临床意义。方法将120例重型颅脑损伤患者根据受伤到行气管切开术的时间分为早期气管切开组(早期切开组)与非早期气管切开组(非早期切开组)各60例,伤后24h内切开气管为早期,伤后24h后切开气管为非早期,观察两组对重型颅脑损伤的疗效影响。结果早期切开组患者在应用呼吸机治疗时间、ICU监护时间、难治性肺炎、并发ALI或者ARDS等方面均优于非早期切开组,具有统计学意义(P<0.05),而在MODS、并发消化道出血、重残死亡等方面比较无显著差异性(P>0.05)。结论对重型颅脑损伤患者行早期经皮扩张气管切开术可以明显改善预后,降低治疗费用,值得临床推广使用。

Early Percutaneous Dilatational Tracheal Incision in Patients with Severe Traumatic Brain Injury

Objective To investigate the clinical significance of severe traumatic brain injury in patients with early percutaneous expansion of tracheal incision.Methods 120 cases of severe traumatic brain injury based on injury to the time of tracheotomy was divided into the early tracheotomy group（early incision group） and non-early tracheotomy group（early incision group）,60 cases in the two groups within 24 hours after injury was performed a tracheotomy for early tracheotomy non-early 24 hours after injury,all of them were observed the effect of severe traumatic brain injury.Results The group of Early cut patients were better than non-early incision group in the treatment time of the ventilator,ICU monitoring time,refractory pneumonia,complicated by ALI or ARDS.There was statisticall significance（P0.05）,while in MODS,complicated by gastrointestinal bleeding,severe disability and death,there was no significant difference（P0.05）.Conclusion The severe traumatic brain injury in patients with early percutaneous dilatational trachea incision can significantly improve the prognosis,reducing the cost of treatment.It is worthy of clinical using.