超早期气管插管在重型颅脑损伤急诊中的应用价值分析

目的：分析超早期气管插管在重型颅脑损伤急诊中的应用价值。方法将120例重度颅脑损伤患者随机分成两组，对照组和观察组各60例。观察组患者在入院2h内行气管插管，对照组则根据病情进展按常规行气管插管。比较两组患者动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）及颅内压变化；比较两组患者肺部感染发生率及预后差异。结果入院后24、72h时，观察组患者PaO2明显高于对照组，而PaCO2和颅内压则明显低于对照组，差异有统计学意义（P＜0．05）。观察组患者肺部感染发生率明显低于对照组患者，日常生活能力（ADL）分级为Ⅰ级和Ⅱ级的比例明显高于对照组，Ⅳ级和Ⅴ级的比例明显低于对照组，差异有统计学意义（P＜0．05）。结论超早期气管插管能有效改善患者的缺氧症状，降低肺部感染发生率，有利于预后，在重型颅脑损伤急诊中具有很高的应用价值。

Application value of ultra-early intubation for the emergency treatment of patients with severe traumatic brain injury

Objective To analyze the application value of ultra-early intubation for the emergency treatment of patients with severe traumatic brain injury （STBI） .Methods A total of 120 patients with STBI were randomly divid-ed into control group（60 cases） ,treated with conventional endotracheal intubation ,and observation group（60 cases） , treated with intubation in 2 h after admission .Arterial partial pressure of oxygen（PaO2 ） ,arterial partial pressure of carbon dioxide（PaCO2 ） ,intracranial pressure ,incidence of lung infection and prognosis were compared between the two groups .Results 24 and 72 h after admission ,PaO2 level of observation group was significantly higher than con-trol group ,but levels of PaCO2 and intracranial pressure were significantly lower （P〈0 .05） .The incidence of lung in-fection in observation group was lower than control group ,and the proportion of patients with class Ⅰ or Ⅱ of activi-ty of daily living（ADL） in observation group was higher ,and the proportion of patients with class Ⅳ or Ⅴ was lower than control group（P〈0 .05） .Conclusion Ultra-early intubation could effectively improve the symptoms of hypoxi-a ,reduce the incidence of lung infection and improve the prognosis ,which might have high application value for the e-mergency treatment of patients with STBI .