改进型口咽通气管在创伤性脑损伤病人抢救中的应用

Application of Modified Oropharyngeal Airway in Emergency Care of Patients with Traumatic Brain Injury

目的探讨改进型口咽通气管在创伤性脑损伤病人抢救中的应用。方法选择作者医院神经外科研究所2011年收治的120例创伤性脑损伤病人,随机分为实验组和对照组各60例,两组患者均放置口咽通气管,实验组给予放置改进型口咽通气管,对照组采用放置传统型口咽通气管。临床观察各组患者的血氧饱和度、呼吸频率、血气水平、肺部痰鸣音、吸痰间隔时间、一次性插管成功率及气道黏膜损伤的变化。结果采用新型口咽通气管血氧饱和度和氧分压上升明显,二氧化碳分压下降,肺部痰鸣音减弱或消失、吸痰间隔时间延长,一次性插管成功率高及气道黏膜损伤少,与对照组比较差异有统计学意义(P<0.05)。结论采用新型口咽通气管能快速恢复机体的血气水平,稳定呼吸频率,有效的清理呼吸道分泌物,减少气道黏膜的损伤,在创伤性脑损伤抢救中值得应用。

Objective To investigate the application of a modified oropharyngeal airway in saving patients with traumatic brain injury.Methods A total of 120 patients with traumatic brain injury admitted to the Department of Neurosurgery at our hospital in 2011 were selected and randomly assigned to modified treatment and control groups(n=60each).The control group received a conventional oropharyngeal airway,and the modified treatment group received a modified oropharyngeal airway.Changes in blood oxygen saturation,respiratory frequency,blood gas levels,sound of phlegm in the lung,time interval between suctioning,success rate of one-time insertion,and tracheal mucosal damage in both groups were measured.Results In patients undergoing modified oropharyngeal airway insertion:the blood oxygen saturation and oxygen partial pressure increased significantly;the partial pressure of carbon dioxide decreased;wheezy phlegm in the lung attenuated or disappeared;the time interval between suctioning lengthened;the success rate of one-time insertion increased;and tracheal mucosal damage decreased compared with those in the control group(P<0.05).Conclusion The modified oropharyngeal airway can rapidly restore blood gas levels,stabilize respiratory frequency,effectively remove respiratory tract excretions and attenuate injury to the tracheal mucosa and it is therefore applicable in emergency treatment of traumatic brain injury.