重症高血压脑出血患者术后即刻行经皮气管切开术对预后的影响

目的探讨重症高血压脑出血患者术后即刻行经皮气管切开术对患者预后的影响。方法回顾性分析2017年1月至2018年12月在重庆市红十字会医院诊治的出血量>50 mL的56例高血压脑出血患者的临床资料,按照气管切开的时机不同分为观察组和对照组,观察组在术后即刻行经皮气管切开术,对照组在术后72 h内行经皮气管切开术。比较两组患者术后再出血发生率、肺部感染发生率、气管套管留置时间、平均住院时间、术后3个月的日常生活能力(ADL)分级及预后情况。结果观察组患者术后肺部感染发生率低于对照组(P<0.05),气管套管留置时间及平均住院时间均短于对照组(P<0.05)。观察组患者预后良好率高于对照组(P<0.05)。两组患者术后再出血发生率、ADL分级和病死率比较,差异均无统计学意义(P>0.05)。结论重症高血压脑出血患者术后即刻行经皮气管切开术可改善患者预后。

Effect of immediate postoperative percutaneous tracheotomy on the prognosis of patients with severe hypertensive intracerebral hemorrhage

Objective To investigate the effect of immediate postoperative percutaneous tracheotomy on the prognosis of patients with severe hypertensive intracerebral hemorrhage.Methods The clinical data of 56 patients with hypertensive intracerebral hemorrhage treated in Chongqing Red-cross Hospital from January 2017 to December 2018 were retrospectively analyzed,the patients were divided into observation group and control group according to the time of tracheotomy.Percutaneous tracheotomy was performed immediately in the observation group and within 72 hours in the control group after the operation.The incidence of postoperative rehemorrhage,pulmonary infection,endotracheal tube indwelling time,average length of stay,ability of daily living(ADL)grade at 3 months after operation and prognosis were compared between the two groups.Results The incidence of postoperative pulmonary infection in the observation group was lower than that in the control group(P<0.05),and the endotracheal tube indwelling time,average length of stay were shorter than those in the control group(P<0.05).The good prognosis rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of postoperative rehemorrhage,ADL grade and mortality between the two groups(P>0.05).Conclusion Percutaneous tracheotomy immediately after the operation can improve the prognosis of patients with severe hypertensive intracerebral hemorrhage.