摘要
目的研究分析早期气管切开术在颅脑外伤和脑出血治疗中的应用价值。方法选取2020年1月—2023年1月南京市六合区人民医院收治的60例颅脑外伤和脑出血患者为研究对象,按照随机数表法分为对照组、研究组,每组30例。对照组在发病24 h后行气管切开术治疗,研究组在发病24 h内行早期切开术治疗,比较两组临床疗效、脑氧代谢情况、血清神经功能指标情况、并发症发生情况。结果研究组临床总有效率明显高于对照组,差异有统计学意义(P<0.05)。与对照组相比,治疗后研究组颈内静脉球氧饱和度、脑氧摄取率更大,脑动脉-静脉氧浓度差更小,差异有统计学意义(P均<0.05)。治疗后研究组胶质纤维酸性蛋白、神经元特异性烯醇化酶、中枢神经特异性蛋白水平明显低于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率(6.67%)明显低于对照组(26.67%),差异有统计学意义(χ^(2)=4.320,P=0.038)。结论早期气管切开术在颅脑外伤和脑出血治疗中的应用价值非常高,不仅可以改善脑氧代谢与神经功能,还可以降低并发症发生率,可取得良好的预后。
Objective To study and analyze the application value of early tracheotomy in the treatment of craniocere⁃bral trauma and cerebral hemorrhage.Methods Sixty patients with craniocerebral trauma and cerebral hemorrhage treated in Liuhe District People's Hospital of Nanjing from January 2020 to January 2023 were selected as the study objects,and were divided into control group and study group according to random number table method,with 30 cases in each group.The control group was treated with tracheotomy 24 h after the onset of the disease,while the study group was treated with early tracheotomy within 24 h after the onset of the disease.The clinical efficacy,cerebral oxy⁃gen metabolism,serum neurological function indexes,and the occurrence of complications of the two groups were com⁃pared.Results The total clinical effective rate of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Compared with the control group,the internal jugular venous oxygen saturation and cerebral extraction rate of oxygen were higher in the study group after treatment,the ce⁃rebral arterial venous oxygen concentration difference was smaller,and the differences were statistically significant(all P<0.05).After treatment,glial fibrillary acidic protein,neuron specific enolase and central nervous system specific protein were significantly lower than those of control group,and the differences were statistically significant(all P<0.05).The complication rate of the study group(6.67%)was significantly lower than that of the control group(26.67%),and the difference was statistically significant(χ^(2)=4.320,P=0.038).Conclusion The application value of early tracheotomy in the treatment of craniocerebral trauma and cerebral hemorrhage is very high,which can not only improve the cerebral oxygen metabolism and neurological function,but also reduce the yearly rate of complications,and can achieve a good prognosis.
作者
董广佩
沈斌
DONG Guangpei;SHEN Bin(Department of Neurosurgery,Liuhe District People's Hospital,Nanjing,Jiangsu Province,211500 China)
出处
《系统医学》
2024年第5期117-120,共4页
Systems Medicine
关键词
颅脑外伤
脑出血
早期气管切开术
临床疗效
并发症
Craniocerebral trauma
Cerebral hemorrhage
Early tracheotomy
Clinical efficacy
Complications
