颅脑外伤术后再次气管插管的危险因素分析

The risk factors of intratracheal re-intubation in patients after craniocerebral trauma surgery

目的分析颅脑外伤术后发生再次气管插管的原因及危险因素。方法收集1607例颅脑外伤术后气管插管拔管患者的病例资料,分析其中167例患者再次气管插管的直接原因及相关危险因素。结果痰液阻塞、舌根后坠、胃内容物返流误吸及原发疾病加重是导致再次插管的直接原因;与拔管成功患者比较,再次插管患者肥胖、格拉斯哥评分、吸烟等情况的差异有统计学意义(P<0.05)。结论正确评估患者、严格掌握拔管指征,可以早期预见再次气管插管的可能性;对已拔除气管插管的患者,要积极做好气道护理,避免患者再次气管插管。

Objective To investigate the reasons and risk factors of intratracheal re-intubation in patients after craniocerebral trauma surgery. Methods The clinical data of 1607 patients who were extubated after craniocerebral trauma surgery were collected. The reasons of risk factors of re-intubation in 167 cases were analyzed. Results Sputum blockage,glossocoma,gastric aspiration and exacerbation of primary disease were common reasons of re-in- tubation. Obesity,the score of Glasgow Coma Scale and smoking were risk factors of re-intubation. Conclusion The possibility of re-intubation can be foreseen by proper assessment. It is suggested to strengthen airway care for patients who were extubated to avoid re-intubation.