Impact of super early tracheotomy in prognosis of patients with massive cerebral hemorrhage: a comparative study / 中华神经医学杂志

ABSTRACT

Objective To study the impact of super early tracheotomy in the prognosis of patients with primary massive cerebral hemorrhage (＞50 mL).Methods A retrospective analysis was conducted on the clinical data of 100 patients with primary massive cerebral hemorrhage who underwent the comprehensive treatment of craniotomy operation plus tracheotomy from January 2010 to December 2013.The patients underwent tracheotomy before brain operation were classified as super early tracheotomy (SET) group,and the patients accepted tracheotomy within 3 days or 4-7 days after brain operation were classified,respectively,as early tracheotomy (ET) group or late tracheotomy (LT) group.Clinical variables such as age,gender,Glasgow coma scale (GCS) scores,postoperative re-bleeding rate,tracheal cannula indwelling time,hospitalization time,improvement rate and mortality were analyzed contrastively among the 3 groups.Results There was no statistical difference in primary clinical characteristics among 3 groups (P＞0.05).The postoperative re-bleeding rate of ET group (14.28％) was higher than one of SET group (5.55％) and LT group (10.34％).The tracheal cannula indwelling mean time of SET group was significantly shorter than one of ET group and LT group (P＜0.05).Significant differences existed among the 3 groups in the mean hospitalization time (SET group＜ET group＜LT group,P＜0.05).There was no significant difference in the improvement rate between SET group and ET group,however,the improvement rate of LT group was significantly lower than one of the other two groups (P＜0.05).No statistical difference in the mortality existed among 3 groups (P＞0.05).Conclusion It is effective and feasible to perform SET to reduce the postoperative re-bleeding rate,shorten the hospitalization time,improve the prognosis of the patients with primary massive cerebral hemorrhage.