气管切开术在严重创伤患者救治中选择时机的分析.docVIP

气管切开术在严重创伤患者救治中选择时机的分析 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：气管切开术在严重创伤患者救治中选择时机的分析 1 1 一般资料 3 2 病例分组 3 1 病例伤型分类(表1) 3 2 两组病例ISS评分和GCS评分比较(表2) 3 文2：经皮扩张气管切开术在危重患者中的应用 6 1 资料与方法 6 1. 2 方法 6 2 结果 7 3 讨论 8 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 10 正文 气管切开术在严重创伤患者救治中选择时机的分析 文1：气管切开术在严重创伤患者救治中选择时机的分析 Abstract: Objective To analyze the outcomes of early tracheostomy for patients with severe The clinical data of 293 patients with severe trauma(ISS≥25) received tracheostomy were collected from 2002 to performed within a week after injury was taken as early group;while tracheostomy performed 1 week after injury was taken as late time of mechanical ventilation,ICU stay,inhospital stay,the rate of pulmonary infection and mortality between early and late tracheostomy patients were The duration of mechanical ventilation was (±) days in early group while (±) days in late group(P).The length of ICU stay in early group and late group was(±) days and (±) days respectively(P).The inhospital stay in early group and late group was (±)days and (±) days respectively(P).The rate of pulmonary infection in early group was % veus % in late group(P).The mortality of early group was % veus % in late group(P).Conclusion The time of tracheostomy in severe trauma patients should take account of patients’s tracheostomy(≤7 days) in severe trauma patients can reduce the duration of mechanical ventilation and the length of ICU stay. Key words：trauma;tracheostomy;mechanical ventilation;inteive care 气管切开术是临床抢救危重患者常用的手段之一,其目的在于保持呼吸道通畅,清除潴留于气管支气管内的分泌物,改善肺泡换气不足,提高血氧浓度,预防坠积性肺部感染。在救治严重创伤患者时，气管切开术已得到越来越广泛的应用，而实行气管切开手术的选择时机及弊端仍存在争论。目前多数观点倾向于早期针对性地行气管切开术，我院对293例严重创伤患者行气管切开术，现回顾性分析如下。 临床资料 1 一般资料 选择我科2002年1月～2007年12月收治的293例严重创伤患者,其中男性198例,女性95例;年龄20～65 岁,平均(±) 岁。损伤严重度评分(injury severity score,ISS)≥ 25 分;合并颅脑损伤患者进行格拉斯哥昏迷评分(glasgow coma scale，GCS) 2 病例分组 伤后1周以内实施气管切开者为早期组206例，超过1周者为晚期组87例。其中给予机械通气的患者早期组96例，晚期组42例。 结 果 应用统计学软件SPSS 对数据进行分析,P为差异有统计学意义。 1 病例伤型分类(表1) 2 两组病例ISS