咽反射在指导昏迷患者拔管中的意义

The significance of gag reflex in the extubatation of endotracheal catheter from patient in a coma

目的评估咽反射在指导昏迷患者拔除气管导管时的作用。方法根据拔管前是否实施咽反射检查将108位患者分为咽反射检查组与对照组，比较两组患者带气管导管时间、住ICU时间、肺炎发生率以及再插管或气管切开率。结果试验组带管时间较对照组短，分别为（5．4±3．0）d和（7．3±3．1）d（P〈0．05），住ICU时间两组分别为（7．2±3．6）d和（9．2±3．7）d（P〈0．05），肺炎发生率分别为35．1％和57．7％（P〈0．05），再插管和气管切开率分别为21．6％和46．5％（P〈0．05），差异均具有统计学意义。结论咽反射可作为预测昏迷患者能否拔管的有效指标。

Objective To evaluate the prediction of gag reflex in extubation from coma patient. Methods 108 cases were divided into two groups according to whether had been done the gag reflex before extubation, one was the gag reflex examing group or experiment group, the other was the control group. The endotracheal catheter insertion time, ICU length of stay, incidence rate of pneumonia and the rate of reintubation or tracheostomy were compared between two groups. Results The endotracheal catheter insertion time in experiment group and control group was （5.4 ±3.0） and （7.3 ±3. 1 ） days respectively ; The time was shorter in experiment group than control group and the difference was significant （ P 〈 0. 05 ） ; The ICU length of stay in two groups was （7.2 ±3.6 ） and （9.2 ±3.7 ） days respectively; the incidence rate of pneumonia and the rate of reintubation or tracheostomy in two groups were 35.1% vs 57.7% and 21.6% vs 46. 5% respectively. All the differences were significant （P 〈 0. 05 ）. Conclusion Gag reflex can be the index of the extubation from coma patient.