CAJ | 학술논문

目的研究早期气管插管对颅脑外伤昏迷患者吸入性肺炎发生率的影响.方法颅脑外伤昏迷患者89例,按急诊科接诊日期随机分为两组,研究组(42例)于急救现场或接诊后立即气管插管;对照组(47例)实施常规气道管理,在需要使用呼吸机时才置入气管插管,其他医疗措施按诊疗常规进行.随访24 h,比较两组性别构成、年龄分布、颅脑损伤严重程度、伤后0.5 h气管插管使用率、伤后4 h呕吐发生率、伤后24 h呼吸机使用率、伤后24 h吸入性肺炎发生率等情况.结果研究组伤后0.5 h气管插管使用率显著高于对照组,伤后24 h吸入性肺炎发生率显著低于对照组(P均＜0.05);两组其他各项指标比较差异均无统计学意义(P均＞0.05).结论早期气管插管可以显著降低颅脑外伤昏迷患者吸入性肺炎发生率,有效保障气道安全.
목적 연구조기기관삽관대로뇌외상혼미환자흡입성폐염발생솔적영향.방법 로뇌외상혼미환자89례,안급진과접진일기수궤분위량조,연구조(42례)우급구현장혹접진후립즉기관삽관;대조조(47례)실시상규기도관리,재수요사용호흡궤시재치입기관삽관,기타의료조시안진료상규진행.수방24 h,비교량조성별구성、년령분포、로뇌손상엄중정도、상후0.5 h기관삽관사용솔、상후4 h구토발생솔、상후24 h호흡궤사용솔、상후24 h흡입성폐염발생솔등정황.결과 연구조상후0.5 h기관삽관사용솔현저고우대조조,상후24 h흡입성폐염발생솔현저저우대조조(P균＜0.05);량조기타각항지표비교차이균무통계학의의(P균＞0.05).결론 조기기관삽관가이현저강저로뇌외상혼미환자흡입성폐염발생솔,유효보장기도안전.
Objective To evaluate the effect of early tracheal intubation on the incidence of aspiration pneumonia for the patients in a coma with craniocerebral trauma. Methods 89 cases with craniocerebral traumatic coma were collected and divided randomly into 2 groups according to the different airway management. The study group (42 cases) accepted tracheal intubation in the first-aid on-site or rescue room, while the control group (47 cases) accepted routine airway care, and tracheal intubation was only used when they needed mechanical ventilation. Both groups got conventional emergency treatment. The follow-up time was 24 hours. The indexes included gender composition, age distribution, severity of head injury, incidence of tracheal intubation within 0.5 hour after the injury, incidence of vomiting within 4 hours after the injury, incidence of mechanical ventilation within 24 hours after the injury, and incidence of aspiration pneumonia within 24 hours after the injury. Results The study group showed significantly higher incidence of tracheal intubations and lower incidence of aspiration pneumonia, compared with control group (P＜0.05), while there were no significant differences in other indexes(P＞0.05). Conclusion Tracheal intubation as early as possible can effectively keep airway unobstructed, significantly reduce the incidence of aspiration pneumonia in craniocerebral traumatic patients due to the inhalation of vomit.