重庆医学
重慶醫學
중경의학
Chongqing Medicine
2015年
32期
4499-4501
,共3页
颅脑损伤%咳嗽%拔管
顱腦損傷%咳嗽%拔管
로뇌손상%해수%발관
craniocerebral trauma%cough%exbuation
目的：探讨自主咳嗽次数对IC U住院颅脑外伤患者拔管效果的预测价值。方法青海省第五人民医院IC U 收治的重型颅脑损伤经人工气道管理患者78例，根据拔管成功与否分为成功组（53例）和失败组（25例）。经患者知情同意后，登记一般资料，同时记录拔管前格拉斯哥昏迷评分（GCS ）总分和自主咳嗽次数情况。结果患者拔管成功53例，失败25例，失败率为32．05％。两组年龄、性别、既往病史、住院获得性肺炎、疾病种类及插管时间比较，差异无统计学意义（P＞0．05），而在吸烟、BMI、GCS总分和自主咳嗽次数差异有统计学意义（P＜0．05）。两组患者撤机参数比较差异均无统计学意义（P＞0．05）。GCS曲线下面积（AUC）为0．822，BMI AUC为0．674，自主咳嗽次数AUC为0．914，吸烟AUC为0．856。结论吸烟、BMI、GCS和自主咳嗽次数均可用来评估颅脑损伤患者的拔管时机，其中自主咳嗽次数准确度最高，是拔管成功的重要预测因素。
目的：探討自主咳嗽次數對IC U住院顱腦外傷患者拔管效果的預測價值。方法青海省第五人民醫院IC U 收治的重型顱腦損傷經人工氣道管理患者78例，根據拔管成功與否分為成功組（53例）和失敗組（25例）。經患者知情同意後，登記一般資料，同時記錄拔管前格拉斯哥昏迷評分（GCS ）總分和自主咳嗽次數情況。結果患者拔管成功53例，失敗25例，失敗率為32．05％。兩組年齡、性彆、既往病史、住院穫得性肺炎、疾病種類及插管時間比較，差異無統計學意義（P＞0．05），而在吸煙、BMI、GCS總分和自主咳嗽次數差異有統計學意義（P＜0．05）。兩組患者撤機參數比較差異均無統計學意義（P＞0．05）。GCS麯線下麵積（AUC）為0．822，BMI AUC為0．674，自主咳嗽次數AUC為0．914，吸煙AUC為0．856。結論吸煙、BMI、GCS和自主咳嗽次數均可用來評估顱腦損傷患者的拔管時機，其中自主咳嗽次數準確度最高，是拔管成功的重要預測因素。
목적：탐토자주해수차수대IC U주원로뇌외상환자발관효과적예측개치。방법청해성제오인민의원IC U 수치적중형로뇌손상경인공기도관리환자78례，근거발관성공여부분위성공조（53례）화실패조（25례）。경환자지정동의후，등기일반자료，동시기록발관전격랍사가혼미평분（GCS ）총분화자주해수차수정황。결과환자발관성공53례，실패25례，실패솔위32．05％。량조년령、성별、기왕병사、주원획득성폐염、질병충류급삽관시간비교，차이무통계학의의（P＞0．05），이재흡연、BMI、GCS총분화자주해수차수차이유통계학의의（P＜0．05）。량조환자철궤삼수비교차이균무통계학의의（P＞0．05）。GCS곡선하면적（AUC）위0．822，BMI AUC위0．674，자주해수차수AUC위0．914，흡연AUC위0．856。결론흡연、BMI、GCS화자주해수차수균가용래평고로뇌손상환자적발관시궤，기중자주해수차수준학도최고，시발관성공적중요예측인소。
Objective To investigate the predictive value of spontaneous cough in extubation patients with craniocerebral in‐jury in ICU .Methods Totally 78 cases of patients with severe craniocerebral injury in ICU was divided into successful exbuation group (53 cases) and failing exbuation group (25 cases) according to the exbuation outcome .With the permission of patients ,the general clinical data ,glasgow coma scale (GCS) scores and spontaneous cough of patients were recorded .Results There were 53 cases suceed ;25 cases of patients failing in exbuation ,accounting for 32 .05% .There were no significant difference between ages , gender ,medical history ,hospital acquired pneumonia (HAP) ,disease kind between two groups (P> 0 .05) ,while had significant difference between smoking ,body mass index (BMI)、GCS scores and spontaneous cough of two groups (P<0 .05) .No significant difference was found between the conventional exbuation parameter of two groups (P> 0 .05) .Receiver operating characteristic curve (ROC) analysis showed that ,GCS scoresarea under the curve (AUC) was 0 .822 ,BMI AUC was 0 .674 ,spontaneous cough AUC was 0 .914 ,and smoking AUC was 0 .856 .Conclusion Smoking ,BMI and GCS scores and spontaneous cough times were all meaningful indices for evaluating exbuation of patients with craniocerebral injury in ICU ,in which spontaneous cough times was an important predictive factor and the most accurate one .
