颈托与口咽通气管在脑卒中昏迷患者开放气道中的应用与效果观察

Application and efficacy of neck support combined with oropharyngeal tube in open airway coma patients with stroke

目的探讨颈托并用口咽通气管在脑卒中昏迷患者气道开放中的应用效果。方法选取2012-10—2013-06我院神经内科收治的脑卒中昏迷患者67例,随机分为实验组34例,对照组33例,在对症治疗基础上,对照组使用口咽通气管进行开放气道,实验组选用合适的口咽通气管+颈托的方法开放气道,开放气道24h后比较2组血氧饱和度、呼吸频率改善情况与通气效果。结果 (1)2组气道开放24h后血氧饱和度与呼吸频率均明显优于气道开放前水平(P<0.05),且实验组血氧饱和度[(97.53±2.87)%]与呼吸频率〔(23.77±2.95)次/min〕改善情况优于对照组[(95.42±3.14)%、(25.67±3.04)次/min],差异均有统计学意义(P<0.05)。(2)2组通气效果构成无明显差异,实验组通气有效率(97.1%)显著高于对照组(81.8%),差异有统计学意义(P<0.05)。结论脑卒中昏迷患者开放气道使用颈托合并口咽通气管可显著提高患者血氧饱和度与改善通气功能障碍,值得临床推广。

Objective To observe and discuss application and efficacy of neck support combined with oropharyngeal tube in open airway patients with stroke .Methods Sixty-seven admitted patients with stroke coma from Oct .2012 to Jun .2013 were selected as study objects ,and randomly divided into experimental group （n=34） and control group （n=33） .Based on symp-tomatic treatment ,patients in control group were applied with oropharyngeal tube airway ,patients in experimental group were given appropriate neck support plus oropharyngeal tube open airway ,and blood oxygen saturation ,respiratory frequency and ventilation efficacy were noted and compared after ventilation for 24h between two groups.Results SpO2 and respiratory frequency of patients in the two groups with open airway for 24 h were significantly better than those before open airway （P〈0.05）.SpO2 （97.53 ± 2.87）% and respiratory frequency （23.77 ± 2.95）times/min of the experimental group were better than those of control group（95.42 ± 3.14）% ,（25.67 ± 3.04）times/min ,the difference was statistically significant （P〈0.05）.There was no significant difference between efficacy proportion on ventilation ,but effective rate of ventilation of the experimental group （97.1% ） was significantly higher than that of control group （81.8% ） ,the difference was statistically significant （P〈0.05）.Conclusion In stroke coma patients ,using neck support combined with oropharyngeal tube in open airway can significantly improve blood oxygen saturation and improve ventilation dysfunction ,and is worth of clinical promotion.