高压氧条件下无阻力气管套管给氧对重型颅脑损伤并肺部感染患者的影响

目的比较重型颅脑损伤气管切开并肺部感染患者高压氧治疗与常压下经气管套管口给氧治疗的效果，探讨在大型压缩空气医用氧舱中无舱内呼吸机的条件下，采用自创吸氧连接装置高压氧治疗的可行性及通气情况。方法重型颅脑损伤气管切开并肺部感染患者60例，按年龄、性别、格拉斯哥昏迷（COS）评分分层后，随机分为高压氧组和对照组，每组30例。两组患者均给予降颅压、保护脑组织、手术（或非手术）、敏感抗菌药物、对症支持和氧气治疗等。对照组在常压下经气管套管采用一次性吸氧管给氧治疗，高压氧组采用我科自创吸氧连接装置进行高压氧治疗。对两组患者的体温、咳嗽咳痰、白细胞总数及分类、肺部听诊变化等情况进行比较。结果高压氧组体温恢复正常、咳嗽咳痰好转、白细胞总数及分类正常、肺部呼吸音清晰的时间明显短于对照组，组间比较差异有统计学意义（P〈0．01）。结论自创吸氧连接装置符合呼吸机呼气末正压通气模式，在压缩空气医用氧舱中无呼吸机辅助呼吸的条件下，对重型颅脑损伤气管切开术后并发肺部感染患者行高压氧治疗具有较好的实用价值。

Analysis of the influence of hyperbaric oxygen therapy on lung infection with severe craniocerebral injury bytracheal cannula

Objective To explore the mode of ventilation and the feasibility of it about using oxygen therapy devices made by oneseff, in the case of no ventilator in large hyperbaric oxygen chamber, by comparing the treatment effectiveness of lung infection with severe brain injury with tracheotomy between hyperbaric oxygen and normal oxygen pressure. Methods Through stratified by age, gender, GCS scores,60 patients of lung infection with severe brain injury with tracheotomy were randomly divided into experimental group （ n = 30） and control group （ n = 30）. Bothgroups were given reduced the intraeranial hypotension, protected the brain, surgery, sensitive antibiotics, symptomatic and support therapy, oxygen therapy. In control group, under normal oxygen pressure, the patients received oxygen therapy by tracheal cannula. In experimental group, the patients received hyperbaric oxygen therapy by oxygen devices made by oneself. The body temperature, cough and expectoration,breath sounds, WBC were compared between the two groups. Results There were statistical difference （P 〈 0. 01 ） in the body temperature, cough and expectoration, breath sounds, the total number of WBC, the time about normal category of WBC between experimental and control group. Conclusion Oxygen therapy devices made by oneself can successfully complete treatment on lung infection with severe brain injury with tracheotomy hy hyperbaric oxygen, in the case of no ventilator in large hyperbaric oxygen chamber. They met the mode of ventilation about positive expiratory end pressure, and have a higher value.