摘要
目的探讨早期机械通气干预对出血性脑卒中术后低氧血症患者的影响。方法选自平煤神马医疗集团总医院2014-12—2016-12收治的出血性脑卒中术后低氧血症患者89例,按照随机数字表法分为观察组45例与对照组44例。2组患者入院后均采用手术开颅清除血肿,术后常规进行鼻导管/面罩吸氧治疗,且进行血气分析和SpO2监测。对照组采用传统机械通气干预,观察组采用早期机械通气干预。比较2组吸入氧浓度、心率、PaO2、中心静脉压、机械通气持续时间、脑积水发生情况,及术后随访6个月GOS评分变化和死亡情况。结果观察组吸入氧浓度和PaO2低于对照组,差异有统计学意义(P<0.05);2组心率和中心静脉压比较差异无统计学意义(P>0.05);观察组机械通气持续时间短于对照组,且差异有统计学意义(P<0.05);观察组脑积水发生率低于对照组,但差异无统计学意义(P>0.05);观察组术后随访6个月GOS评分高于对照组,病死率低于对照组,均差异有统计学意义(P<0.05)。结论早期机械通气干预对出血性脑卒中术后低氧血症患者效果显著,具有重要研究意义。
Objective To investigate the effect of early mechanical ventilation on postoperative hypoxemia in patients with hemorrhagic stroke.Methods 89 cases in our hospital from December 2014 to December 2016 with hypoxemia after operation were divided into observation group（45 cases）and control group（44 cases）according to the random number table method.Two groups of patients were treated with craniotomy to remove hematoma after surgery,conventional nasal catheter/mask oxygen therapy,and blood gas analysis and SpO2 monitoring.The control group was treated with conventional mechanical ventilation,while the observation group was treated with early mechanical ventilation.Inhaled oxygen concentration,heart rate,PaO2,central venous pressure,duration of mechanical ventilation,hydrocephalus,and postoperative follow-up of 6 months GOS score changes and death were compared.Results The observation group inhaled oxygen concentration and PaO2 were significantly lower than the control group（P〈0.05）;no significant difference of heart rate and central venous pressure were found between the two groups（P〉0.05）;the observation group had a shorter duration of mechanical ventilation than the control group（P〈0.05）;the observation group had average lower incidence of hydrocephalus than that of control group,but with no significant difference（P〉0.05）;After6 months of follow-up GOS score of the observation group was higher than the control group,the incidence of hydrocephalus was lower than the control group（P〈0.05）.Conclusion The effect of early mechanical ventilation on postoperative hypoxemia in patients with hemorrhagic stroke is significant.
作者
王星利
WANG Xingli(Department of Intensive Care Unit, Pingdingshan Shenma Medical Group General Hospital,Pingdingshan 467000,Chin)
出处
《中国实用神经疾病杂志》
2018年第9期975-978,共4页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关计划项目
编号:201503037
关键词
早期机械通气
出血性脑卒中
术后低氧血症
开颅清除血肿
脑积水
Early mechanical ventilation
Hemorrhagic stroke
Postoperative hypoxemia
Craniotomy to removehematoma
Hydrocephalus
