紧急气管插管对重型颅脑损伤患者在院前急救中的意义

Significance of emergency tracheal intubation in pre-hospital first aid for patients with severe craniocerebral injury

目的 探讨紧急气管插管对提高重型颅脑损伤患者院前急救成功率的临床意义。方法 选取2010年1月~2014年12月院前急救中重型颅脑损伤且符合入组条件的患者172例进行研究,将所有研究对象按照入院时间奇偶数分为两组：院前紧急气管插管组86例,入院后常规气管插管组86例,比较两组的GOS预后评定结果。结果 院前紧急气管插管组GOS预后评定良好率、中度残疾率、植物状态率分别为13.95%、41.86%,8.14%,常规气管插管组患者GOS预后评定良好率、中度残疾率、植物状态率分别为4.65%、24.42%、20.93%,院前紧急气管插管组良好率、中度残疾率明显高于常规气管插管组,植物状态率明显低于常规气管插管组（P〈0.05）。结论 在院前急救中对重型颅脑损伤患者尽早紧急气管插管,可大大降低其死亡率和致残率。

Objective To investigate the clinical significance of emergency tracheal intubation in improving the success rate of pre-hospital first aid for patients with severe craniocerebral injury.Methods 172 qualified cases with severe craniocerebral injury in pre-hospital first aid from January 2010 to December 2014 were selected and studied and they were divided into two groups according to the odd and even number of admission time：pre-hospital emergency tracheal intubation group （86 cases） and post-hospital routine tracheal intubation group after admission （86 cases）.The result of GOS prognosis evaluation was compared between two groups.Results Good rate,moderate disability rate and plantation state rate for GOS prognosis evaluation in pre-hospital emergency tracheal intubation group was 13.95%,41.86% and 8.14% and it was 4.65%,24.42% and 20.93% respectively in post-hospital routine tracheal intubation group.Good rate and moderate disability rate of pre-hospital emergency tracheal intubation group was significantly higher than that of post-hospital routine tracheal intubation group,while the plantation state rate of pre-hospital emergency tracheal intu- bation group was significantly lower than that of post-hospital routine tracheal intubation group （P〈0.05）.Conclusion E- mergency tracheal intubation applied in the pre-hospital emergency for patients with severe craniocerebral injury as soon as possible can greatly reduce the mortality and disability rate of patients.