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目的观察早期纤支镜介入治疗在重型颅脑损伤并误吸患者中的应用效果。方法选取2014—2015年西安医学院第二附属医院收治的重型颅脑损伤并误吸患者72例,根据治疗方法分为对照组29例和观察组43例。两组患者均给予常规治疗,观察组患者在此基础上给予早期纤支镜介入治疗。比较两组患者机械通气时间、入住ICU时间、抗生素使用时间、治疗1个月后肺部并发症发生率及病死率。结果观察组患者机械通气时间、入住ICU时间、抗生素使用时间均短于对照组(P<0.05)。治疗1个月后,观察组患者吸入性肺炎、急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)、肺不张、呼吸功能不全发生率均低于对照组(P<0.05);两组患者病死率比较,差异无统计学意义(P>0.05)。结论早期纤支镜介入治疗在重型颅脑损伤并误吸患者中的应用效果良好,能有效缩短患者机械通气时间、入住ICU时间、抗生素使用时间,降低肺部并发症发生率。
Objective To observe the effect of early interventional therapy of bronchoscopy in patients with severe traumatic brain injury and aspiration. Methods Seventy-two patients with severe craniocerebral injury who were admitted to the Second Affiliated Hospital of Xi’an Medical College from 2014 to 2015 were divided into control group (n = 29) and observation group (n = 43) according to the method of treatment. Two groups of patients were given conventional treatment, the observation group patients on the basis of early bronchoscopic interventional therapy. The mechanical ventilation time, ICU stay time, antibiotic use time and the incidence of pulmonary complications and mortality after 1 month of treatment were compared between the two groups. Results The observation group patients with mechanical ventilation time, ICU stay time, antibiotic use time were shorter than the control group (P <0.05). One month after treatment, the incidences of aspiration pneumonia, acute lung injury / acute respiratory distress syndrome (ALI / ARDS), atelectasis and respiratory insufficiency in the observation group were significantly lower than those in the control group (P <0.05) The mortality of patients was no significant difference (P> 0.05). Conclusion Early interventional therapy with bronchoscopy is effective in patients with severe craniocerebral injury and aspiration, which can effectively shorten the duration of mechanical ventilation, ICU stay, duration of antibiotics and the incidence of pulmonary complications.