预防性气管插管在严重创伤急救中的价值  

The value of preventive tracheal intubation in the first-aid of serious severe trauma

作　　者：李天泉[1,2] 张文军[1,2] 徐世伟[3] 

机构地区：[1]重庆医科大学附属第一医院綦江医院 [2]重庆市綦江区人民医院重症医学科,401420 [3]第三军医大学西南医院急救部,重庆400038

出　　处：《重庆医学》2015年第29期4092-4094,共3页Chongqing medicine

基　　金：重庆市医学科研计划项目(2012-1-108)

摘　　要：目的评估早期预防性气管插管在严重创伤早期急救中价值,提高严重创伤早期急救能力。方法采用回顾性研究258例严重创伤引起急性气道梗阻患者根据,观察达到梗阻标准和呼吸衰竭为对照组(n=84),出现有气道梗阻趋势进行预防性气管插管为观察组(n=174),比较平均住院时间、多器官功能衰竭发生率、病死率。结果观察组的伤员平均住院时间17.2d,多器官功能衰竭发生率44.59%,病死率10.67%。对照组平均住院时间27.9d,多器官功能衰竭发生率67.51%,病死率33.75%,两组比较差异有统计学意义(P<0.05)。结论早期预防性气管插管可对严重创伤进行较好气道管理,改善呼吸,缩短严重创伤患者住院日、降低并发症;对提高抢救成功率有重要意义。Objective To evaluate the value of early preventive tracheal intubation in the early first-aid of serious severe trauma and improve the early first-aid ability of serious severe trauma.Methods Using retrospective study,among 258 patients of acute airway obstruction caused by severe trauma,those who have reached the standard of obstruction and respiratory failure according to observation were as the contrast group（n=84）,and those who had the tendency of airway obstruction instant treatment of preventive trachea intubation were as early preventive tracheal intubation group（n=174）.The average in hospital days,the occurrence rate of multiple organ failure and death rate were contrasted.Results In the early preventive tracheal intubation group,in hospital days were 17.2on average,the occurrence rate of multiple organ failure was 44.59% and the death rate was 10.67%.In the contrast group,it was 27.9d,67.51%and 33.75%,the two groups had shown significant difference（P〈0.05）.Conclusion Early trachea intubation have a good trachea management of serious severe traumas,improve inspiration,shorten the hospitalization days,and reduce the occurrence rate of complication.It is important to improving rescuing rate.

关 键 词：创伤和损伤 急救 预防性 气管插管 

分 类 号：R641[医药卫生—外科学]