关键词: 脑血管病; 气管切开术; 肺炎; 交叉感染; 病死率

Abstract: Objective To assess the applying of tracheotomy in early stage in severe stroke patients.Methods We investigated 102 stoke patients who underwent endotracheal intubation in 48 hours after admission retrospectively. All the patients were divided into two groups, early tracheotomy group (n=55) who underwent tracheotomy within 5 days after endotracheal intubation, and delayed tracheotomy group (n=47) who underwent tracheotomy after 5 days. We compared the mortality, dosage of sedative, incidence of hospital acquired pneumonia(HAP), duration of mechanical ventilation and hospitalization in intensive care unit(ICU) of the two groups.Results Early tracheotomy could reduce the duration of mechanical ventilation(178±94 h vs 266±162 h, P=0.03) and hospitalization in ICU(10±5 d vs 13±5 d, P=0.006), and it could also reduce the duration of antibiotic(19±4 d vs 12±4 d, P=0.03) and the dosage of sedative significantly(138.72±38.77 mg vs 186±48 mg, P=0.001). However there was no significant difference in mortality (29.1% vs 36.2%, P=0.45) and incidence of HAP(49.1% vs 63.8%, P=0.13) between the early tracheotomy group and delayed tracheotomy group.Conclusion Severe stroke patients can get some benefit from early tracheotomy.

Key words: Cerebrovascular disease; Tracheotomy; Pneumonia; Cross infection; Mortality