早期机械通气应用于急性重型颅脑损伤患者的临床研究(1)
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【摘要】 目的 探讨重型颅脑损伤患者早期机械通气的治疗效果及其护理。方法 将250例GCS评分5~8分的重型颅脑损伤患者依有否进行早期机械通气分为实验组128例及对照组122例，两组均行脑损伤常规治疗护理，及时准确的机械通气的监测，正确选择呼吸机模式和参数，加强人工气道的护理及基础护理。对治疗前后两组患者的氧饱和度(SaO2)、氧分压(PaO2)、二氧化碳分压(PaCO2)、血压(BP)、心率(HR)、GCS评分和预后进行评估。结果 治疗后实验组与对照组间的氧饱和度(SaO2)、氧分压(PaO2)、二氧化碳分压(PaCO2)比较差异有统计学意义(P<0.05)。随访6个月，实验组GCS评分、死亡率、预后较对照组明显改善，差异有统计学意义(P<0.05)。结论 重型颅脑损伤后呼吸功能衰竭发生率高; 早期机械通气能较早改善重型颅脑损伤患者的缺氧症状。正确合理地应用呼吸机, 并给予针对性的护理,有助于纠正损伤后低氧血症, 减少并发症, 提高生存质量。
【关键词】机械通气;颅脑损伤;氧饱和度;护理
The clinical study of early mechanical ventilation in the treatment of patients with severe craniocerebral injury
Yan Yan-ling, Li Yun-ling, Luo Jin-ling, et al.
The First People’s Hospital of Zhaoqing City,Zhaoqing 526021,China
【Abstract】 Objective To explore the effect and nursing care in acute severe craniocerebral injury patients treated by early stage ventilation.Methods 250 patients(GCS 5-8)with severe craniocerebral injury were divided into the treatment group(n=128)and control group(n=122)according to whether early mechanical ventilation. The routine treatment and nursing were performed for all patients, monitoring the mechanical ventilation in time, a correct choice of ventilation modes and parameters, and strengthening the nursing of artificial airway and basic nursing. The oxygen saturation(SaO2), oxygen partial pressure(PaO2), partial pressure of carbon dioxide(PaCO2), blood pressure(BP), heart rate(HR), GCS score and prognosis in two groups were compared and assessed before and after treatment. Results The differences in SaO2, PaO2 and PaCO2 between treatment group and control group were statistically significant after treatment(P<0.05). Followed up for six months, the GCS score, mortality and prognosis in the treatment group was better than that in the control group(P<0.05). Conclusion There is a high incidence of respiratory function failure in patients with severe craniocerebral injury. Early stage mechanica lventilation may assure ventilation in severe craniocerebral injury patients ......
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