早期气管切开对重型颅脑损伤并发肺部感染的干预作用研究

目的观察早期气管切开对重型颅脑损伤并发肺部感染的防治作用及对预后影响。方法回顾分析100例重型颅脑损伤患者的临床病历资料,按1∶1分为观察组和对照组,每组各50例,对照组进行常规治疗,观察组在对照组基础上,行早期气管切开,在术后24h以内实施,比较两组的肺部感染发生率、感染控制率、感染控制时间及病死率的差异,利用SPSS16.0进行统计分析。结果观察组肺部感染为32%,对照组为90%,观察组的肺部感染率明显低于对照组,P<0.01;观察组感染控制率为81.25%,观察组感染控制时间为(6.4±1.7)d;对照组感染控制率为28.89%,感染控制时间为(15.8±3.4)d,观察组感染控制率明显低于对照组,感染控制时间明显缩短,P<0.01;观察组病死率为18%,对照组病死率为52%,观察组病死率明显低于对照组,P<0.01。结论早期气管切开能有效降低重型颅脑损伤术后并发的肺部感染的概率,减轻感染病情程度,缩短感染控制疗程,降低病死率,推荐临床适当实施治疗。

The Study of Intervention of Early Tracheotomy on Severe Head Injury with Lung

Objective To observe Preventive effect of early tracheotomy on severe head injury with lung and impact on prognosis.Methods Make a retrospective analysis of 200 cases of severe head injury patients,divided into two groups according to 1：1,the observation group and the control group,Each group of the 100 patients,the control group were given conventional treatment,observation group were given early tracheotomy based on the control group,implemented within 24h after surgery,the incidence of lung infection,infection control rate,time of infection control and mortality differences were compared between two groups,using SPSS16.0 for statistical analysis.Results The lung infection rate of observation group was 33%,the control group was 90%,the observation group of lung infection was significantly lower than the control group,P〈0.01;the infection control rate of observation group was 78.79%,the infection control time of the observation group were（6.4±1.7）d;the infection control rate of control group were 28.89%,the infection control time of the control group were（15.8±3.4）d,the infection control rate of Observation group was significantly lower than the control group,the infection control time was significantly shorter,P〈0.01;the died rate of observation group mortality was significantly lower than the control group,P〈0.01.Conclusion Early tracheostomy can reduce the rate of postoperative severe head with lung infection,reduce the severity of infection,shorter course of infection control and reduce mortality,recommended the implementation of appropriate clinical treatment.