摘要目的:探讨隆德概念对重型颅脑外伤患者呼吸机相关性肺炎的影响。方法:抽取2017年8月至2019年12月常熟市第一人民医院重症医学科诊断为重型颅脑外伤的患者150例，采用随机数字表法将其分为对照组和治疗组，每组75例。对照组患者给予常规治疗，治疗组患者应用隆德概念进行治疗，根据病情两组患者连续治疗7～14 d，比较两组患者呼吸机相关性肺炎发生率，肺部感染第1、3、7天C-反应蛋白，白细胞计数及体温峰值，气管切开率，机械通气时间，ICU住院时间、抗生素使用时间，90 d病死率。结果:治疗组呼吸机相关性肺炎(VAP)发生率，VAP第1天及第3天C-反应蛋白、白细胞计数及体温峰值与对照组比较，差异未见统计学意义( P>0.05)，治疗组VAP第7天C-反应蛋白、白细胞计数及体温峰值低于对照组，差异有统计学意义( P<0.05)；治疗组气管切开率、ICU住院时间及机械通气时间低于对照组，差异有统计学意义( P<0.05)；治疗组抗生素使用时间低于对照组，随访90 d病死率低于对照组，差异有统计学意义( P<0.05)。 结论:隆德概念并未增加重型颅脑外伤患者呼吸机相关性肺炎的发生率，其能缩短患者机械通气时间，降低气管切开率，减少ICU住院时间，降低病死率。

abstractsObjective:To investigate the effect of Lund concept on severe craniocerebral injury and its influence on ventilator-associated pneumonia.Methods:A total of 150 patients who were diagnosed with severe craniocerebral injury from August 2017 to December 2019 in the Department of Critical Care Medicine of the First People’s Hospital of Changshu City were selected. And they were divided into the control group ( n=75) and the treatment group ( n=75) according to random number table method. Patients in the control group received conventional treatment, meanwhile, patients in the treatment group received Lund concept treatment. Both groups continuously treated for 7-14 days according to their condition. The incidence of pulmonary infection, C-reactive protein, white blood cell count and temperature, rate of tracheotomy, duration of mechanical ventilation, ICU stays, duration of antibiotics, and 90-day mortality were compared between the two group. Results:There were no significant differences between the two groups in the incidence of VAP, C-reactive protein, white blood cell count and temperature peak on the first and third day ( P>0.05), however, C-reactive protein, white blood cell count and peak temperature on the seventh day of VAP in the treatment group were significantly lower than those in the control group. Meanwhile, the rate of tracheotomy, ICU stays and duration of mechanical ventilation in the treatment group were also significantly lower than those in the control group. We also found that the duration of antibiotics and the mortality rate at 90 days in the treatment group were significantly lower than that in the control group respectively. Conclusions:Using the Lund concept on severe craniocerebral injury patients does not increase the incidence of VAP, however, it can significantly shorten the time of mechanical ventilation, reduce the rate of tracheotomy, the length of ICU stays, the cost of hospitalization, and reduce mortality