气管切开术作为中枢神经系统疾病重症监护的一个组成部分

A. M. Karamyshau, A. V. Leonau, P. A. Shcharbakova, A. L. Hrybach
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引用次数: 0

摘要

目标。通过比较呼吸支持和ICU的持续时间、发生呼吸机相关性肺炎的频率、格拉斯哥昏迷量表(GCS)的意识水平评估、生存率、并发症发生率,揭示中枢神经系统疾病患者气管切开术的有效和安全时机。材料和方法。对2010年至2017年接受气管切开术治疗的神经和神经外科患者进行了回顾性研究。131例患者根据气管切开术时间分为3组。探讨中枢神经系统病变患者早期气管造口术与呼吸支持时间、ICU卧床天数、发生呼吸机相关性肺炎的概率的关系;本组患者气管切开术时间与神经预后及生存率无相关性。早期气管切开术用于中枢神经系统病变患者的重症监护是有效的,机械通气时间减少2.2倍,ICU天数减少1.9倍,发生呼吸机相关性肺炎的风险降低1.6倍,不影响预后,并且由于手术干预期间和术后没有大量并发症,因此是安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tracheostomy as a component of intensive care for central nervous system diseases
Objective. To reveal the effective and safe timing of tracheostomy in patients with CNS diseases by comparative assessment of the duration of respiratory support and ICU, the frequency of development ventilator-associated pneumonia, the assessment of the level of consciousness according to the Glasgow Coma Scale (GCS), survival rate, as well as the incidence of complications rate.Materials and methods. A retrospective study was conducted among neurological and neurosurgical patients treated from 2010 to 2017 who underwent tracheostomy. Patients (n=131) were divided into 3 groups depending on the tracheostomy time.Results. The relation between early tracheostomy and the duration of respiratory support, the ICU bed-day, the probability of developing ventilator-associated pneumonia in patients with the central nervous system pathology was revealed; no relationship was found between the tracheostomy time and the neurological outcome and survival rate in this category patients.Conclusion. The use of early tracheostomy in intensive care of patients with the central nervous system pathology is effective, which is proved by a 2,2 times reduction of the duration of mechanical ventilation, by a 1.9 times reduction of the duration of the ICU day, by a 1.6 times lower risk of developing ventilator-associated pneumonia, without affecting outcomes and being safe due to the absence a lot of complications both during and after the surgical intervention.
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