發(fā)布時(shí)間：2019-03-05 08:15

【摘要】：目的探討急性頸脊髓損傷需要長(zhǎng)時(shí)間機(jī)械通氣患者氣管切開(kāi)的最佳時(shí)機(jī)。方法回顧性分析2011年1月~2015年12月我科79例接受氣管切開(kāi)手術(shù)的急性頸脊髓損傷的臨床資料。按氣管切開(kāi)距氣管插管的時(shí)間將患者分為2組,甲組患者氣管切開(kāi)距氣管插管≤10 d,乙組患者氣管切開(kāi)距氣管插管10 d,比較2組患者機(jī)械通氣時(shí)間、ICU住留時(shí)間、肺部感染發(fā)生率有無(wú)差異。結(jié)果甲組患者機(jī)械通氣時(shí)間(192±58)h較乙組(348±53)h明顯縮短(t=-12.490,P=0.000)。甲組患者ICU時(shí)間(9.8±2.7)d明顯短于乙組(15.9±2.2)d(t=-11.058,P=0.000)。甲組患者肺部感染發(fā)生率16.2%(6/37),明顯低于乙組38.1%(16/42)(χ~2=4.686,P=0.030)。2組成功撤離機(jī)械通氣的例數(shù)分別為34、38例,無(wú)統(tǒng)計(jì)學(xué)差異(χ~2=0.000,P=1.000)。結(jié)論對(duì)于短時(shí)間內(nèi)不能撤離機(jī)械通氣的急性頸脊髓損傷患者,早期氣管切開(kāi)可減少機(jī)械通氣時(shí)間,縮短ICU住留時(shí)間,降低肺部感染發(fā)生率。
[Abstract]:Objective to explore the optimal time of tracheotomy in patients with acute cervical spinal cord injury who need long-term mechanical ventilation. Methods the clinical data of 79 patients with acute cervical spinal cord injury who underwent tracheotomy from January 2011 to December 2015 were retrospectively analyzed. According to the time of tracheotomy and tracheal intubation, the patients were divided into two groups: group A (tracheotomy distance from tracheal intubation 鈮，

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