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目的探讨重型脑外伤患者早期实施机械通气的价值。方法将81例重型脑外伤患者随机分为对照组和观察组。两组均按常规进行内科治疗及相应的手术治疗;对照组38例先予鼻导管持续吸氧,出现呼衰时使用机械通气;观察组43例伤后或术后即刻实施机械通气;比较两组通气前后动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧饱和度(SaO2)等血气指标变化及伤后半年格拉斯哥预后评分(GOS)。结果两组患者机械通气后PaO2、PaCO2、SaO2等血气指标变化均有显著改善,但观察组通气效果更好,通气时间更短;GOS显示,观察组生存质量优于对照组(P<0.05)。结论对重型脑外伤患者早期实施机械通气能更有效改善重型脑外伤患者的缺氧状态,缩短机械通气时间,能改善生存者的生存质量。
Objective To investigate the value of early mechanical ventilation in patients with severe traumatic brain injury. Methods 81 cases of severe traumatic brain injury were randomly divided into control group and observation group. The two groups were routinely underwent medical treatment and the corresponding surgical treatment. In the control group, 38 patients were given nasal continuous oxygen inhalation and mechanical ventilation during respiratory failure. Mechanical ventilation was performed in 43 cases immediately after or immediately after operation in the observation group. Before and after ventilation, arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), oxygen saturation (SaO2) and other blood gas changes and Glasgow prognostic score (GOS) after six months. Results The changes of PaO2, PaCO2, SaO2 and other blood gas indexes were significantly improved in both groups after ventilation, but the observation group had better ventilation and shorter ventilation time. The GOS showed that the quality of life in the observation group was better than that of the control group (P <0.05) . Conclusion The early implementation of mechanical ventilation in patients with severe traumatic brain injury can effectively improve the hypoxic state of patients with severe traumatic brain injury, shorten the duration of mechanical ventilation and improve the quality of life of survivors.