Affection of blood pressure regulation combined with completely mechanical ventilation on the prognosis of patients with severe craniocerebral trauma after craniotomy
-
摘要: 目的 采用血压调控联合完全机械通气治疗重症颅脑损伤开颅术后患者,观察术后脑氧摄取率(CERO2),随访3个月内好转率与病死率。 方法 选择神经外科2013年7月-2015年6月重症颅脑损伤开颅术后患者54例,采用随机数字表法分为观察组28例和对照组26例。对照组采用ICU常规治疗;观察组采用ICU常规治疗合并血压调控及完全机械通气。比较2组患者一般情况,术前、术毕即刻、24、48、72小时CERO2变化情况,随访3个月或终点事件(死亡)情况,比较2组预后。 结果 2组患者一般情况中,观察组呼吸机使用时间长于对照组,差异有统计学意义(P<0.05)。观察组术后24、48、72小时CERO2较对照组降低,差异有统计学意义(P<0.05),提示该治疗方法对术后降低CERO2有一定效果。观察组好转率53.57%,病死率3.57%;对照组好转率15.38%,病死率30.77%,观察组好转率高于对照组,病死率低于对照组,差异有统计学意义(P<0.05)。 结论 重症颅脑损伤患者开颅术后血压调控联合完全机械通气可降低CERO2,改善患者预后。治疗过程中需要注意呼吸机相关医院感染的防治,确保治疗效果。Abstract: Objective Observation of blood pressure regulation combined with completely mechanical ventilation in the treatment of patients with severe craniocerebral trauma after craniotomy.The cerebral oxygen uptake rate (CERO2) after surgery,the improvement rate and mortality rate in 3 months were observed,the influence of the method on the prognosis of severe craniocerebral trauma were observed. Methods Fifty-four cases of severe craniocerebral trauma patients from July,2013 to June,2015 were selected and randomly divided into observation group and control group by means of random number table,28 cases in the observation group and 26 cases in the control group.The control group was given conventional ICU treatment.The observation group was given conventional ICU treatment,blood pressure regulation and complete mechanical ventilation.Compare the two groups with general situation,24,48,72 hours CERO2 changes before and after the surgery.Followed up with patients for 3 months or end point events (death).Compare the prognosis of the two groups. Results The use time of the breathing machine observation group was significantly longer than that of the control group (P< 0.05).The observation group after surgery 24,48,72 hours of CERO2 was significantly reduced,compared with the preoperative and control group,the difference was statistically significant (P<0.05),which showed that the treatment method had a certain effect on reducing the CERO2.The improvement rate of observation group was 53.57% and control group was 15.38%,the mortality rate of observation group was 3.57% and control group was 30.77%,the improvement rate of observation group was higher than that of control group,the mortality rate was lower than the control group,the difference was statistically significant (P<0.05). Conclusion The blood pressure control combined with completely mechanical ventilation can reduce the CERO2 in the patients with severe traumatic brain trauma and improve patient outcomes.Attention should be paid to the prevention and treatment of ventilator associated nosocomial infection.
点击查看大图
计量
- 文章访问数: 64
- HTML全文浏览量: 15
- PDF下载量: 1
- 被引次数: 0