改良经皮气管旋切术对重症脑出血昏迷患者手术指标、早期意识水平及生活质量的影响

Abstract
Figure/Table
References (19)
Related Citation (15)

Download: PDF (0 KB) HTML (44 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore the effect of modified percutaneous tracheostomy on the surgical index, early consciousness level and quality of life in patients with severe cerebral hemorrhage and coma. Methods A total of 140 patients with severe cerebral hemorrhage and coma treated in the Department of Neurosurgery, People′s Hospital of Huaiji County in Zhaoqing City, Guangdong Province from January 2016 to February 2020 were selected as the research objects, and divided into control group and study group by random number table method, with 70 cases in each group.The patients in control group underwent conventional tracheostomy, and the study group underwent modified percutaneous tracheostomy. The bispectral index (BIS) and Glasgow coma scale (GCS) were used to assess the level of early consciousness, and the short-form 36 item health survey questionnaire (SF-36) was used to assess the quality of life.Followed up for 3 months, the surgery-related indicators, early consciousness level, and quality of life changes before and after 3 months of operation between the two groups were compared. Results The incision size of the study group was smaller than that of the control group, the operation time was shorter than that of the control group, the intraoperative blood loss and propofol usage were lesser than those of the control group, and the differences were statistically significant (P＜0.05). There were no statistically significant differences in the postoperative BISmean and GCSmean between the study group and the control group (P＞0.05).The postoperative BISmax of the study group was lower than that in the control group, and the BISmin was higher than that in the control group, and the differences were statistically significant (P＜0.05). There were no statistically significant differences in physiological function, psychological function, cognitive function, emotional function, role function, and total quality of life scores between the two groups before operation (P＞0.05). Postoperative 3 months, the physiological function, psychological function, cognitive function, emotional function, role function, the total quality of life scores were higher than those preoperative, and the differences were statistically significant (P＜0.05). Postoperative 3 months,the physiological function, psychological function, cognitive function, emotional function, role function, the total quality of life scores of the study group were higher than those of the control group, and the differences were statistically significant (P＜0.05). Conclusion Compared with conventional tracheotomy, modified percutaneous tracheostomy has a shorter operation time, smaller incision, less intraoperative blood loss, and less anesthetic use, which can effectively improve the early consciousness of patients with severe cerebral hemorrhage and coma, and improve the quality of life.

Key words： Modified percutaneous tracheostomy Cerebral hemorrhage Coma Surgical indicators Early awareness;Quality of life

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LI Bao-jia
	SUN Xin-lin
	MO Quan
	LAI Wei-feng
	ZHOU Xiu-chuan

Cite this article:

LI Bao-jia,SUN Xin-lin,MO Quan, et al. Effect of modified percutaneous tracheostomy on the surgical index, early consciousness level and quality of life in patients with severe cerebral hemorrhage and coma[J]. 中国当代医药, 2020, 27(25): 65-69.

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2020/V27/I25/65

[1]	Oomura M，Fujioka T，Uchida Y，et al.Fatal remote cerebral hemorrhage at a site of a microbleed immediately after intravenous thrombolysis[J].Neurol Clin Neurosci，2017，5（4）：118-120.
[2]	钟新云，黄汉文，钟宏丽，等.盐酸纳洛酮联合正中神经电刺激对脑出血昏迷病人的催醒作用[J].中西医结合心脑血管病杂志，2017，15（20）：116-118.
[3]	Trouillet JL，Collange O，Belafia F，et al.Tracheotomy in the intensive care unit：Guidelines from a French expert panel：The French Intensive Care Society and the French Society of Anaesthesia and Intensive Care Medicine[J].Anaesth Crit Care Pain Med，2018，37（3）：281-294.
[4]	周璞真，左云霞.脑电双频指数监测对胃肠外科全麻手术患者麻醉恢复时间影响的回顾性队列研究[J].中国循证医学杂志，2018，18（6）：565-569.
[5]	陆敏，张静.急性脑损伤患者熵指数与格拉斯哥昏迷评分的相关性研究[J].中华危重病急救医学，2018，30（1）：47-50.
[6]	陈晓杰，陈英伟，董建增，等.有氧运动对阵发性房颤患者射频消融术后复发、运动功能和生活质量的影响[J].中国康复，2019，34（2）：82-86.
[7]	Hondebrink L，Rietjens SJ，Brunt TM，et al.Fatalities，Cerebral Hemorrhage，and Severe Cardiovascular Toxicity After Exposure to the New Psychoactive Substance 4-Fluoroamphetamine：A Prospective Cohort Study[J].Ann Emerg Med，2018，71（3）：294-305.
[8]	Adami D，Berkefeld J，Platz J，et al.Complication rate of intraarterial treatment of severe cerebral vasospasm after subarachnoid hemorrhage with nimodipine and percutaneous transluminal balloon angioplasty：Worth the risk?[J].J Neuroradiol，2019，46（1）：15-24.
[9]	罗醒政，刘力新.682 例经皮穿刺气管切开术无中转传统气管切开的临床应用[J].中国急救复苏与灾害医学杂志，2017，12（9）：908-909.
[10]	冀宏斌，刘强，张艳艳，等.经皮气管切开术与传统气管切开术在临床应用的比较[J].川北医学院学报，2017，32（6）：861-863.
[11]	熊学辉，魏小川，罗杰，等.经皮气管切开术在神经外科急危重症病人中的应用体会[J].中国临床神经外科杂志，2019，24（5）：61-62.
[12]	冯丽芝，周青山，夏文芳，等.改良经皮气管切开术在危重症患者中的应用效果[J].湖南中医药大学学报，2017，37（9）：989-991.
[13]	李江，曾坤.改良经皮气管切开术在重症脑出血患者抢救中的应用[J].西南国防医药，2018，28（5）：39-41.
[14]	季云，卢丽华，姜新娣.全面无反应性量表和格拉斯哥昏迷评分量表对神经重症监护病房患者意识障碍和短期预后的评估价值比较[J].解放军护理杂志，2019，36（9）：18-21.
[15]	蔡兴涛，徐明禹，丁登峰，等.脑电双频指数对全麻下老年患者腹腔镜胃癌根治术术后认知功能障碍的影响[J].广东医学，2017，38（18）：2793-2795.
[16]	陶守君，雷卫平，黄娅琴，等.国产麻醉深度监测仪和脑电双频指数监测仪在腹腔镜手术中的一致性分析[J].临床麻醉学杂志，2018，34（9）：878-881.
[17]	黄昌琴，杨淑青，劳传毅，等.脑电双频指数在早期评估急性脑损伤昏迷患者昏迷程度和预后中的应用[J].卒中与神经疾病，2019，26（2）：99-102.
[18]	李涛，闫燕，朱丽，等.改良经皮扩张气管切开术的临床应用[J].中国微创外科杂志，2017，17（11）：1021-1024.
[19]	陈强，刘娟丽，许雪侠.改良经皮扩张气管切开术的临床应用研究[J].世界中医药，2017，12（S2）：201.