患者胸部外伤脑外伤后合并ARDS,需长期应用呼吸机支持呼吸。41天后出现气管食管漏,给予行经气切瘘口气管插管,深度向下超过原来气管套管气囊位置,旷置瘘口,15天后肺部情况好转,脱离呼吸机。1月后瘘口愈合,拔出气切内气管插管,患者好转出院。

Objective To study the characteristic of epidemiology and rules oftrauma on the road traffic accidents of Lahsa and explore the emergency distribution rules.In order to provide the bases data for clinical medical practice. Methods The statistical analysis was carried out in 258 cases of injury on the road traffic accident.Results The male and female ratio in 4.06 to 1.The average age is 39.96.and the mode age is 33,P25 is 20 and P75 is 45.The age of 20～49 group is accounted for 67.8%.Craniocerebral and cervical,lower limb and thoracic injury were reported in the first three places.The fracture of craniocerebral,lower limb and thoracic were reported in the first three places.Conclusions More males than females in 258 cases.The age of 20~49 group is accounted for the most.Craniocerebral and cervical injury is accounted for the most,especially craniocerebral injury.Craniocerebral frasture is accounted for the most.Injury parts and frasture sites are consistent

目的总结床旁经皮穿刺气管置管术(PDT)在临床中应用的体会。方法回顾性分析我院ICU实施PDT救治8例危重患者的临床资料。结果 8例患者PDT操作均顺利完成,手术时间平均其中30分钟,1例出现并发出血。结论较传统气管切开术,对危重患者实施PDT,耗时短,操作简捷,手术成功率高,手术创伤小,并发症少。

目的探讨高血压脑出血引起高钠血症的病因、临床特点及其预后。方法回顾性分析28例并发高钠血症的高血压脑出血患者,观察血钠程度与预后的关系。结果高钠血症是高血压脑出血患者的严重并发症,也会进一步加重脑损伤。血钠水平愈高,预后愈差。结论血钠水平可作为高血压脑出血患者的一项重要监测指标,对判断预后及指导治疗有重要意义。严密监测血清电解质,尽早发现高钠血症,控制恶性增高,可降低死亡率。

西藏高原平均海拔4000米以上,世居藏族高血压患病率为25.91%是平原地区的4倍,脑出血占脑血管疾病的60.55%.由于人民生活水平低,保健和自我保健意识差,许多高血压病患者不能得到及时、正规、系统的治疗,而最终导致高血压脑出血.