早期机械通气与常规机械通气对重型颅脑损伤救治效果的比较

目的比较早期机械通气与常规机械通气对重型颅脑损伤患者的救治效果。方法将74例格拉斯哥昏迷评分（GCS）3～8分的重型颅脑损伤患者随机分为对照组和观察组。除常规治疗及相应手术治疗外．对照组35例先予鼻导管持续吸氧．出现呼吸衰竭时使用机械通气；观察组39例伤后即刻应用机械通气。比较两组通气前后动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）、氧饱和度（SaO2）等血气指标变化及伤后6个月格拉斯哥预后评分（GOS）。结果两组患者机械通气后PaO2、PaCO2、SaO2等血气指标均有显著改善，但观察组通气效果更好，通气时间更短。结论早期机械通气较常规机械通气能更有效改善重型颅脑损伤患者的缺氧状态，缩短机械通气时间。

Comparison between Curative Effects of EarIy Ventilation and Conventional Ventilation on Patients with Severe Traumatic Brain Injury

Objective To compare the curative effects of early ventilation and conventional ventilation on patients with severe traumatic brain injury. Methods Seventy-four patients with severe traumatic brain injury （Glasgow coma scale： 3-8m patients） were divided into two groups, i.e. the control group （n=35） and the observation group （n=39）. All patients received routine medical and surgical treatments. In the control group, the patients inhaled continuously oxygen through the nasal tubes and received mechanical ventilation when respiratory failure occurred. In the observation group, the patients received mechanical ventilation immediately after the brain injury. Blood gas indices including arterial partial pressure of oxygen （PaO2）, arterial partial pressure of carbon dioxide（PaCO2） and arterial oxygen saturation （SaO2） before and after the mechanical ventilation were compared between the control group and the observation group. According to Glasgow outcome scale（GOS）, the prognosis of the patients in both the groups was evaluated 6 months after the treatment. Results Blood gas indices including PaO2, PaCO2 and SaO2 were significantly improved after the mechanical ventilation in two groups compared to before the ventilation （P〈0.05）. The improvement of the blood gas indices was significantly better and the duration of mechanical ventilation was significantly shorter in the observation group than those in the control group （P〈0.05） 6 months after the treatment. Conclusion Early ventilation can more effectively improve hypoxia and induce the duration of mechanical ventilation in patients with severe traumatic brain injury compared to conventional ventilation.