摘要
为探讨气管切开术在急性重症颅脑损伤救治中的应用价值 ,对 1 997年间我院行气管切开的 37例急性重症颅脑损伤患者进行了分析。 37例患者GCS评分 3～ 8分 ,其中保守治疗 1 4例 ,急诊手术治疗 2 3例。气管切开后常规进行了痰培养及药敏试验。结果 :37例中生存 2 7例 ,死亡 1 0例 ,病死率 2 7.0 %。气管切开后 94 .6%呼吸改善 ,78.4 %动脉血氧饱和度 (SaO2 )完全纠正 ,1 8.9%SaO2 改善。痰培养显示气管切开后易出现耐药菌株感染 ,对常用的传统抗生素如青霉素等耐药率高达 84 .6% ,泰能的耐药率最低为 1 4 .3%。提示早期气管切开可有效改善通气 ,纠正低氧血症。气管切开后应常规进行痰培养 ,根据痰培养结果选择有效的抗生素。
To summarize the application of tracheotomy in treatment of acute severe brain injuries, 37 cases of acute severe brain injury patients with tracheotomy admitted to the department in 1997 were analyzed. All the scores of GCS were 3 to 8 points. Fourteen cases accepted conservative treatment, other 23 cases with emergency operation. Sputum bacterial cultures and drug sensitive tests were routinely carried out after tracheotomy. Twenty seven cases survived and 10 were dead(27.0%). After tracheotomy, the respirations were improved in 35 cases(94.6%) and SaO 2 turned normal in 29 cases( 78.4% ). The bactera of pneumonia infections were commonly drug resistant. Tienam had the lowest resistant ratio(14.3%). Sputum bacterial culture should be done routinely after trachotomy and the drugs can be selected according the result. Transtrocheal medication of antibiotics is a safe and effective methold to treat pulmonary infection.
出处
《首都医科大学学报》
CAS
2001年第2期157-159,共3页
Journal of Capital Medical University
关键词
颅脑损伤
气管切开术
痰培养
救治
brain injuries
tracheotomy
sputum bacterial culture
