中国全科医学2017，Vol.20Issue(5)：554-557,4.DOI:10.3969/j.issn.1007-9572.2017.05.010
早期机械通气干预对出血性脑卒中术后低氧血症患者预后的影响研究
Effect of Early Mechanical Ventilation Intervention on Prognosis of Patients with Hypoxemia after Hemorrhagic Stroke Surgery
摘要
Abstract
Objective To study the effect of early mechanical ventilation on the prognosis of patients with hypoxemia after hemorrhagic stroke surgery. Methods By prospective randomized controlled study design,144 patients with hypoxemia after hemorrhagic stroke surgery admitted into Harrison International Peace Hospital Attached to Hebei Medical University from January 2010 to March 2013 were selected. With random number table method,the patients were randomly assigned to three groups and each group had 48 cases. Group A( active intervention group of mechanical ventilation in early stage)was given continuous monitoring of SpO2 and blood gas analysis after operation. When the average SpO2 continued for two hours was between 93% and 95% and/ or the average PaO2 between 71 and 80 mm Hg(1 mm Hg = 0. 133 kPa),that was the active early stage to perform mechanical ventilation. Group B( intervention group of mechanical ventilation in early stage)was given mechanical ventilation when the average SpO2 continued for two hours was between 91% and 92% and/ or the average PaO2 between 61 and 70 mm Hg. Group C(control group,conservative mechanical ventilation group)was not given mechanical ventilation until the average SpO2 continued for two hours was equal to or less than 90% and/ or the average PaO2 equal to or less than 60 mm Hg. The incidence rate of ventilator - associated pneumonia( VAP),postoperative rebleeding and hydmcephalus,the duration of mechanical ventilation,the score of Glasgow Outcome Scale(GOS)at the sixth month of the follow - up and case fatality rate of patients were recorded in the study. Results There was no significant difference in the incidence rate of VAP,postoperative rebleeding and hydmcephalus and case fatality rate of patients in three groups(P > 0. 05). There was significant difference in the duration of mechanical ventilation and GOS score of patients in three groups( P < 0. 05);and the duration of mechanical ventilation of patients in group A and B was shorter than that in group C,and their GOS score was higher than that in group C(P< 0. 05);there was no significant difference in the duration of mechanical ventilation and GOS score of patients in group A and B (P > 0. 05). Conclusion Early mechanical ventilation can shorten the duration of mechanical ventilation of patients with hypoxemia after hemorrhagic stroke surgery and improve their prognosis.关键词
脑出血/连续气道正压通气/预后Key words
Cerebral hemorrhage/Continuous positive airway pressure/Prognosis分类
医药卫生引用本文复制引用
杨雪辉,朱宁,李晓卫,童莉,张文超..早期机械通气干预对出血性脑卒中术后低氧血症患者预后的影响研究[J].中国全科医学,2017,20(5):554-557,4.基金项目
河北省科技支撑计划资助项目 （）
