【摘要】 目的探讨院前与院内气管插管对急性重型颅脑损伤患者的救治效果。方法选择2015年5月~2017年5月在我院诊断治疗的急性重型颅脑损伤(GCS评分≤8分)患者196例,采用随机数字表法将其分为院前气管插管组(94例)和院内气管插管组(102例),比较两组患者的一般资料,呼吸生理指标变化,预后及患者机械通气及ICU入住时间、并发症情况。结果两组患者一般资料比较,差异无统计学意义(P>0.05);院前组插管后的各项呼吸生理指标优于插管前,差异有统计学意义(P<0.05);院内组插管后的各项呼吸生理指标优于插管前,差异有统计学意义(P<0.05),院前组插管后的各项呼吸生理指标优于院内组,差异有统计学意义(P<0.05);早期院前组气管插管预后良好率高于院内组,差异有统计学意义(P<0.05);院前组气管插管预后不良率低于院内组,差异有统计学意义(P<0.05);院前组并发症情况的比较均低于院内组,差异有统计学意义(P<0.05),两组的ICU入住时间、机械通气时间均低于院内组,差异有统计学意义(P<0.05)。结论院前早期气管插管可以改善急性重型颅脑损伤患者的氧合,减轻低氧血症的发生,减少误吸的发生,降低吸入性肺炎发生率,可以提高患者的预后良好率。更多还原

【Abstract】 Objective To explore the effects of pre-hospital intubation and in-hospital intubation in patients with acute severe craniocerebral injury.Methods 196 patients with acute severe craniocerebral injury(GCS ≤8 point) diagnosed and treated in our hospital from May 2015 to May 2017 were randomly divided into pre-hospital endotracheal intubation group(94 cases) and in-hospital endotracheal intubation group(102 cases).The general data,changes of respiratory physiological indexes,prognosis,mechanical ventilation,ICU stay time and complications were compared between the two groups.Results There was no significant difference in general data between the two groups(P>0.05).The respiratory physiological indexes of pre-hospital group were better than those of pre-hospital group(P<0.05).The respiratory physiological indexes after intubation in the hospital group were better than those before intubation,the difference was statistically significant(P <0.05).The respiratory physiological indexes after intubation in the pre-hospital group were better than those in the hospital group,the difference was statistically significant(P<0.05).The prognosis of tracheal intubation in the early pre-hospital group was higher than that in the hospital group,the difference was statistically significant(P<0.05).The poor prognosis rate of tracheal intubation in pre-hospital group was lower than that in hospital group,the difference was statistically significant(P<0.05).The complications in pre-hospital group were lower than those in hospital group,the difference was statistically significant(P <0.05).The time of ICU stay and mechanical ventilation in both groups were lower than those in hospital group,the difference was statistically significant(P<0.05).Conclusion Pre-hospital early endotracheal intubation can improve oxygenation of patients with acute severe craniocerebral injury,reduce or avoid the happening of hypoxemia,avoid or reduce the occurrence of aspiration,reduce the incidence of aspiration pneumonia,improve the prognosis of patients with good rates.更多还原