早期经皮扩张气管切开对老年危重患者预后的影响被引量：2

Effects of early percutaneous dilational tracheostomy on prognosis of elder critical ill patients

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摘要目的比较早期与延迟经皮扩张气管切开术(PCT)对老年危重患者的影响。方法 143例行PCT的患者,根据气管切开时间分为早期气管切开术(E组,n=65)和延迟气管切开术(D组,n=78)二组,记录二组患者一般情况,气管切开当天APACHEⅡ和昏迷评分,ICU留滞时间,28 d ICU病死率,在院病死率等;同时记录二组患者肺部感染情况、致病菌类型、呼吸机支持天数等。结果 E组的ICU留滞时间和呼吸机支持的时间明显短于D组[分别为(13.6±5.2)d比(18.8±6.3)d;(18.6±3.3)d比(26.4±4.3)d,P均<0.05],但两组的28 d ICU病死率及总病死率无显著性差别(P>0.05)。同时,两组患者肺部感染发生率无显著性差别(P>0.05),且两组患者细菌性肺炎的发生率也相近(P>0.05),但D组肺部真菌感染却明显多于E组(35.0%比52.9%,χ2=5.029,P<0.05)。结论早期气管切开对危重患者的病死率和肺部感染率无明显影响,但可缩短危重患者ICU留滞时间和呼吸机支持时间,并可减少患者发生真菌感染的概率。 Objective To compare effects of percutaneous tracheostomy（PCT） timing to critical ill patients.Method The 143 critical ill patients were divided into early PCT group（E Group,n=65） and delayed PCT group（D Group,n=78） according to the timing.The general data of patients,APACHEⅡ scores and Glasgow coma scores,days of ICU stay,mortality of 28 days and in hospital were recorded.Meanwhile,pneumonia,pathogen and lengths of ventilator support were recorded.Results Days of ICU stay or lengths of ventilator support of E Group were significantly shorter than that of D Group（13.6±5.2days vs 18.8±6.3days,18.6±3.3days vs 26.4±4.3days respectively,both of P〈0.05）.However,mortality of 28 days or in hospital was similar（P〈0.05）.Although the pneumonia incidence was also similar in both groups,the D group was suffered more fungus infection（35.0% vs 52.9%,χ2=5.029,P〈0.05）.Conclusion Although early PCT had no significant effect on mortality or pneumonia incidence of critical patients,it would decrease not only length of ICU stay and ventilator support,but also incidence of fungus infection.

作者胡元威万小健卞金俊朱科明韩文军邓小明

机构地区第二军医大学附属长海医院麻醉科

出处《实用医药杂志》 2011年第6期489-491,共3页 Practical Journal of Medicine & Pharmacy

关键词经皮扩张气管切开术老年危重患者预后 Percutaneous tracheostomy Elder critical ill patient Prognosis

分类号 R605.97 [医药卫生—急诊医学]

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