【摘要】：目的探討早期機械通氣干預對出血性腦卒中術(shù)后低氧血癥患者預后的影響。方法采用前瞻性隨機對照研究設(shè)計,選取2010年1月—2013年3月河北醫(yī)科大學附屬哈勵遜國際和平醫(yī)院收治的出血性腦卒中術(shù)后低氧血癥患者144例,采用隨機數(shù)字表法分為3組,每組48例。A組:積極的早期機械通氣干預組,患者術(shù)后給予持續(xù)末梢血氧飽和度(Sp O_2)及血氣分析監(jiān)測,當持續(xù)2 h平均Sp O_2在93%~95%和/或平均動脈血氧分壓(Pa O_2)在71~80mm Hg(1 mm Hg=0.133 k Pa),即積極的早期給予機械通氣。B組:早期機械通氣干預組,當持續(xù)2 h平均Sp O_2在91%~92%和/或平均Pa O_2在61~70 mm Hg,給予機械通氣。C組:保守機械通氣組,待持續(xù)2 h平均Sp O_2≤90%和/或平均Pa O_2≤60 mm Hg,才給予機械通氣。記錄患者呼吸機相關(guān)性肺炎(VAP)、術(shù)后再出血、腦積水發(fā)生率、機械通氣持續(xù)時間,術(shù)后隨訪6個月時格拉斯哥預后量表(GOS)評分及病死率。結(jié)果 3組患者VAP、術(shù)后再出血、腦積水發(fā)生率及病死率比較,差異均無統(tǒng)計學意義(P0.05)。3組患者機械通氣持續(xù)時間及GOS評分比較,差異均有統(tǒng)計學意義(P0.05);其中A組和B組患者機械通氣持續(xù)時間短于C組,GOS評分高于C組(P0.05);A組與B組患者機械通氣持續(xù)時間及GOS評分比較,差異均無統(tǒng)計學意義(P0.05)。結(jié)論早期機械通氣能夠縮短出血性腦卒中術(shù)后低氧血癥患者機械通氣持續(xù)時間,改善預后。
[Abstract]:Objective to investigate the effect of early mechanical ventilation on the prognosis of patients with hypoxemia after hemorrhagic stroke. Methods 144 patients with hypoxemia after hemorrhagic stroke were selected from January 2010 to March 2013 in Hallieson International Peace Hospital of Hebei Medical University. The patients were randomly divided into 3 groups. 48 cases in each group. Group A: positive early mechanical ventilation intervention group, patients received continuous peripheral blood oxygen saturation (Sp O 2) and blood gas monitoring after operation. Mean Sp O _ 2 at 93% and / or mean Pa O _ 2 at 71~80mm Hg (1 mm Hg=0.133 k Pa),) were given early mechanical ventilation in group B.Group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, group B: early mechanical ventilation intervention group, When the mean Sp O _ 2 lasted for 2 hours, 92% of the patients were given mechanical ventilation at 91% and / or the average Pa O _ 2 at 61 mm Hg,. Group C: conservative mechanical ventilation group, mean Sp O _ 2 鈮，

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