早期气管插管在急诊中重度创伤性脑损伤患者抢救中的应用价值  

The Application Value of Early Endotracheal Intubation in the Emergency Rescue of Patients with Severe Traumatic Brain Injury

作　　者：蔡加鹏 CAI Jiapeng(Emergency Department of Clinical College,School of Medicine,Yangzhou University,Lishui District Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 211200,China)

机构地区：[1]南京市溧水区中医院/扬州大学医学院临床学院急诊科,江苏南京211200

出　　处：《中国医药指南》2025年第4期116-119,共4页Guide of China Medicine

摘　　要：目的探究早期气管插管在急诊中重度创伤性脑损伤患者抢救中的应用价值。方法选择2021年9月至2024年5月南京市溧水区中医院/扬州大学医学院临床学院收治的103例中重度创伤性颅脑损伤患者为对象,根据气管插管时间不同对患者进行分组,对照组(n=52)出现意识障碍30 min后进行气管插管,观察组(n=51)出现意识障碍30 min内进行气管插管,对比两组血流动力学指标(心率、呼吸、血压)、脑灌注情况[脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)]、并发症发生情况。结果插管后,观察组患者心率、MTT、TTP水平及并发症总发生率均低于对照组,呼吸、血压、CBF、CBV水平均高于对照组(均P<0.05)。结论早期气管插管在急诊中重度创伤性脑损伤患者的抢救中的应用,能够有效改善患者血流动力学指标及脑灌注情况,并降低呼吸窘迫综合征、肺部感染等并发症的发生率。Objective To explore the application value of early endotracheal intubation in the emergency rescue of patients with severe traumatic brain injury.Methods A total of 103 patients with moderate to severe traumatic brain injury admitted to the emergency department of Nanjing Lishui District Hospital of Traditional Chinese Medicine/Clinical College,Yangzhou University Medical College hospital from September 2021 to May 2024 were selected as the subjects.Patients were divided into two groups according to different intubation times.The control group(n=52)underwent intubation 30 minutes after the onset of consciousness disorders,while the observation group(n=51)underwent intubation within 30 minutes of the onset of consciousness disorders.The hemodynamic indicators,cerebral perfusion,and incidence of complications were compared between the two groups.Results After intubation,patients in the observation group had lower heart rates,MTT,TTP levels and total complication rates than those in the control group,and higher levels of respiration,blood pressure,CBF and CBV than those in the control group(all P<0.05).Conclusions Early endotracheal intubation has significant application value in the rescue of patients with severe traumatic brain injury in the emergency department.It can effectively improve the patient’s hemodynamic indicators,improve cerebral perfusion,and reduce the incidence of complications such as respiratory distress syndrome and pulmonary infection.

关 键 词：气管插管 创伤性脑损伤 急诊抢救 血流动力学 脑灌注 并发症 

分 类 号：R651.15[医药卫生—外科学]