下颌前托法开放气道配合喉罩通气在颈椎损伤院前急救中的应用研究

Mandibular Tropsch open the airway with the LMA in cervical spine injury in the pre-hospital emergency application

目的探讨下颌前托法开放气道配合喉罩通气在颈椎损伤院前急救中的应用效果。方法对2009年8月至2011年12月石家庄市井陉矿区医院收治的128例颈椎损伤患者相关资料进行分析,根据不同治疗方法将患者分为对照组和实验组,对照组采用常规气管插管方法进行通气治疗,实验组采用下颌前托法开放气道治疗,比较两组疗效。结果实验组93.8%对治疗方案疗效显著,明显优于对照组(疗效有效率为81.3%)(P<0.05);实验组93.8%对方案疗效满意,显著高于对照组(满意率达到65.6%)(P<0.05);实验组(喉罩组)与对照组(气管插管组)在置管成功率、平均置管时间、对颈椎的二次损伤和气道损伤方面均优于气管插管组(P<0.05);喉罩组与气管插管组通气效果差异不显著(P>0.05);实验组ADL评分为(16.2±3.7)分,颈椎功能评分为(59.6±7.5)分,心理功能评分为(65.8±9.2)分,社会功能评分为(57.2±6.5)分,均高于对照组(P<0.05)。结论颈椎损伤患者治疗过程中采用下颌前托法开放气道配合喉罩通气治疗效果理想,值得推广使用。

Objective To investigate the mandibular open airway by dragging with the LMA application results in cervical spine injury in the pre-hospital care. Methods From July 2009 to December 2011, 128 cases of cervical spine injury patients in Jingxing mining area hospital admitted to hospital-related data for analysis,according to the different methods of treatment were divided into a control group and the experimental group and the control group with conventional methods of endotracheal intubation ventilation therapy,the experimental group were dragged before the jaw act open the airway treatment,two groups were compared. Results 93.8% of the experimental group therapy a significant effect,significantly better than the control group(efficacy rate was 81.3%)(P<0.05). 93.8% of the experimental group satisfaction program efficacy was significantly higher(satisfaction rate of 65.6 %)(P<0.05). laryngeal mask group and intubation success rate of catheter group, the average catheterization time, in terms of the cervical spine injury secondary damage and airway intubation group were superior(P<0.05) laryngeal mask ventilation group and intubation group was not significantly different effect(P>0.05). ADL scores for the experimental group(16.2±3.7) points, cervical score was(59.6±7.5) points, psychological function score was(65.8±9.2) points, the social function score was(57.2±6.5) points, were higher(P<0.05).Conclusion The treatment of patients with cervical spine injury in the process of using mandibular open airway by dragging with the LMA ideal treatment effect, should be introduced.