【摘要】 目的探讨不同时机行气管切开术对大量脑出血患者外科治疗预后的影响。方法回顾性分析2014年1月至2015年10月间于我院行外科手术治疗的96例大量脑出血患者的临床资料,依据气管切开时间点的不同分为A、B、C三组,其中A组36例患者于术中行气管切开,B组32例患者于术后3 d内行气管切开,C组28例患者于术后3~7 d行气管切开。比较三组患者之间的肺部感染发生率、气管套管留置时间、平均住院时间及死亡率。并观察患者术后2个月的日常生活能力评分(ADL)分级情况。结果 A组患者的肺部感染发生率以及死亡率最低,好转率最高,B组次之,C组最差,三组之间比较差异具有统计学意义(P<0.05)。三组患者术后均有再出血发生,B组患者发生率略高于其余两组,但三组之间比较差异无统计学意义(P>0.05)。三组之间气管套管留置时间比较,A组明显低于其余两组,差异具有统计学意义(P<0.05)。A组患者的平均住院时间最短,C组最长,差异具有统计学意义(P<0.05)。A组患者2月后的日常生活能力最好,B组次之,C组最差,三组之间比较差异具有统计学意义(P<0.05)。结论术中行气管切开有助于降低大量脑出血外科治疗患者术后再出血率,减少住院时间,并改善预后。更多还原

【Abstract】 Objective To study the effect of different timing tracheotomy on the patients with massive cerebral hemorrhage underwent surgical treatments. Methods Retrospectively analysis was carried out in 96 patients with massive cerebral hemorrhage treated with surgical treatment in our hospital from January 2014 to October 2015. According to the different timing of tracheotomy,the patients were divided into three groups.There were 36 cases of group A underwent tracheotomy in the process of brain operation,32 cases of group B accepted tracheotomy within 3 days after operation,and 28 cases of group C accepted tracheotomy within 3 ~ 7days after operation. The incidence of pulmonary infection,tracheal tube indwelling time,the average length of hospital stay and mortality were analyzed contrastively among the 3 groups. The ADL classification of patients were analyzed after two months. Results The pulmonary infection incidence and mortality of group A were the lowest,followed by group B,and group C was the worst( P < 0. 05). All three groups of patients occurred postoperative hemorrhage again,but there was no statistically significant difference among the three groups( P > 0. 05). The tracheal tube indwelling time of group A was lower than that of the other two groups( P < 0. 05). The average hospitalization time of group A was shortest,and that of group C was the longest( P < 0. 05). The activity of daily living in group A was the best,followed by group B,and group C was the worst( P < 0. 05). Conclusion It is effective and feasible to perform super early tracheotomy to reduce the postoperative re-bleeding rate,shorten the hospitalization time,and improve the prognosis of the massive cerebral hemorrhage patients.更多还原