气管切开时机不同对重度颅脑损伤患者肺部感染影响.docVIP

气管切开时机不同对重度颅脑损伤患者肺部感染影响 　　【摘要】 目的 探讨不同时期行气管切开手术对重度颅脑损伤患者肺部感染的影响。方法 95例行气管切开的重度颅脑损伤患者依据气管切开的时间不同分为早期气管切开组（早期组）43例和晚期气管切开组（晚期组）52例， 比较两组患者在颅脑损伤后7、28 d时肺部感染评分（CPIS）的变化， 以及两组中CPIS评分≥6分患者所占的比例。结果 早期气管切开组患者在颅脑损伤后7 d时CPIS（5.67±0.99）分低于晚期气管切开组（6.23±0.68）分， 同时CPIS评分≥6分患者所占的比例早期气管切开组也低于晚期气管切开组， 差异均有统计学意义（Plt;0.05）;而颅脑损伤后28 d时， 两组CPIS差异无统计学意义（Pgt;0.05）， 但CPIS评分≥6分患者所占的比例， 早期气管切开组仍低于晚期气管切开组， 差异有统计学意义（Plt;0.05）。结论 重度颅脑损伤患者48 h内行气管切开手术治疗有利于肺部感染控制， 减轻肺部感染的严重程度， 因此对于有指征的重度颅脑损伤患者建议早期行气管切开治疗。 　　【关键词】 气管切开;肺部感染评分;重度颅脑损伤 　　DOI：10.14163/j.cnki.11-5547/r.2015.03.011 　　Influence of tracheotomy in different time periods on pulmonary infection of patients with severe craniocerebral injury WANG Jian， LIU Shuai， FU Yu-dong. Department of SICU， Beijing Huairou Hospital， Beijing 101400， China 　　【Abstract】 Objective To discuss the influence tracheotomy in different time periods on the pulmonary infection of patients with severe craniocerebral injury. Methods By different time of tracheotomy， a total of 95 patients with severe craniocerebral injury were divided into early tracheotomy group （early group） with 43 cases and late tracheotomy group （late group） with 52 cases. The changes of clinical pulmonary infection score （CPIS） and proportion of CPIS≥6 after 7 d and 28 d of craniocerebral injury were compared between the two groups. Results The CPIS score of the early tracheotomy group after 7 d of craniocerebral injury was （5.67±0.99） points， which was lower than （6.23±0.68） points of the late tracheotomy group. The proportion of patients with CPIS≥6 in the early tracheotomy group was also lower than the late tracheotomy group. The differences had statistical significance （Plt;0.05）. After 28 d of craniocerebral injury， there was no statistically significant difference of CPIS between the two groups （Pgt;0.05）. The proportion of patients with CPIS≥6 in the early tracheotomy group was still lower than the late tracheotomy group， and the difference had statistical significance （Plt;0.05）. C