Abstract:
Objective To explore the clinical effect of early tracheotomy in the treatment of severe traumatic brain injury (sTBI) in the elderly and its influence on blood gas index, infection and prognosis.
Methods One hundred and six elderly patients with sTBI admitted to our hospital from 2016 to 2018 were randomly divided into control group and observation group, 53 cases in each group. All patients were treated with the same basic treatment. The control group received tracheotomy more than 24 h after injury, while the observation group received tracheotomy less than 24 h after injury. The effects of treatment effect, blood gas index changes, hospitalization, pulmonary infection rate and mortality were compared between the two groups.
Results The duration of mechanical ventilation, ICU hospitalization, total hospitalization time and infection control time in the observation group were significantly less than those in the control group (P<0.05). The incidence of pulmonary infection in the observation group was significantly lower than that in the control group, while the infection control rate was significantly higher than that in the control group, the difference was statistically significant (P<0.05). The levels of PaO2, PaCO2, SpO2 and PaO2/FiO2 at 48 h after treatment in both groups were significantly different from those before treatment (P<0.05). The levels of PaO2, SpO2 and PaO2/FiO2 in the observation group were significantly higher than those in the control group 48 h after treatment (P<0.05), and PaCO2 levels were significantly lower than those in the control group (P<0.05). There was no significant difference in the distribution of GOS scores between the two groups (P>0.05). There was no significant difference in mortality between the observation group and the control group (P>0.05).
Conclusion Early tracheotomy less than 24 h after injury is more conducive to improve hypoxemia, ventilation function and brain tissue hypoxia in elderly patients with sTBI, reducing the incidence of pulmonary infection and shortening hospitalization time. It is worth popularizing and applying.
Key words:
Early tracheotomy,
Severe traumatic brain injury,
Blood gas index,
Infection
Jinbao Gao, Wende Li, Yunjun Li, Haijiang Wang. Effect of early tracheotomy on severe traumatic brain injury in elderly patients and its influence on prognosis[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2018, 04(06): 349-352.