气道管理小组在重度获得性脑损伤患者拔除气切套管中的作用

The role of airway management group in tracheotomy decannulation in patients with severe acquired brain injury

目的研究气道管理小组在重度获得性脑损伤(sABI)患者拔除气切套管的应用。方法回顾性将2017年10月—2020年12月首都医科大学附属复兴医院康复中心连续住院的sABI患者38例编入对照组,将2021年1月—12月收治的患者41例编入研究组,研究组实施气道管理小组模式。收集纳入患者的基线资料,以及患者住院时间、气管带管时间、住院费用、患者拔管后的咳嗽能力、误吸发生率、吞咽功能、肺炎发生率、抗生素使用率等信息。结果研究组患者住院时间和人工气道留置时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05)。研究组拔管后误吸发生率、肺炎发生率和抗生素使用率低于对照组,差异有统计学意义(P<0.05)。结论气道管理小组在sABI患者拔除气切导管的过程中起到了积极的作用,气道管理小组通过多学科的康复治疗与护理,可缩短气切套管留置时间和住院时间,降低患者住院费用,促进患者吞咽功能恢复和有效咳嗽,降低肺部感染率,减少抗生素的使用。

Objective To investigate the role of airway management group in removing tra⁃cheotomy cannula for patients with severe acquired brain injury(sABI).Methods This retrospective study enrolled sABI patients with tracheotomy tubes who underwent rehabilitation in Rehabilitation Medicine Center from October 2017 to December 2021.All the subjects were divided into the airway management group as experiment group and routine group as control group.There were 38 patients into control group and 41 patients into experiment group.The characteristics of the length of hospital stay,the time of tracheotomy,hospitalization expenses,and after decannulation,the effective cough,incidence of aspiration,swallowing function,pneumonia infection and antibiotic using rate were used to analyze the factors associated with rehabilitation.Results Patients in the study group had shorter average length of hospital stay,shorter period of indwelling tracheal tube and lower total hospital costs compared with those in the control group(P<0.05).The incidence of aspiration following extubation,aspiration pneumonia and rate of using antibiotics in the study group were lower than those in the control group(P<0.05).Conclusion The airway management group can effectively improve the comfort of sABI patients,moreover it is potentially effective to reduce the incidence of aspiration and pulmonary infection,reduce the hospitalization expenses and shorten the length of hospital stay.