The clinical efficacy and prognosis of prehospital and early endotracheal intubation in patients with acute severe craniocerebral injury
ZHANG Wen-jun
XU Zhi-hui
ZHOU Xian-ping
LIU Yong-fu
DAI Yue
YAN Xiao-jia
YANG Min
Abstract：Objective To analyze the clinical efficacy and prognosis of prehospital and early endotracheal intubation in patients with acute severe craniocerebral injury.Methods The clinical data of 420 patients with acute severe craniocerebral injury from Jan.2008 to Dec.2014 in our hospital were retrospectively analyzed.Among them 285 were males,135 were females with an average age of 45.3(19-70) years.260 cases were injured from traffic accidents,75 were injured from high falling,64 were injured from strikes and 20 were from other injuries.According to the timing of tracheal intubation,these patients were divided into the early tracheal intubation group (within 2 hours,191 cases) and delayed tracheal intubation group (more than 2 hours,229 cases).Before intubation,1d and 3d after intubation,the changes of blood gas parameters and intracranial pressure were analyzed,and the incidence of pulmonary infection,mortality and activities of daily living (ADL) grade for six months were compared.Results Compared with before tracheal intubation,the levels of arterial oxygen pressure (PaO2),oxygen saturation (SpO2) at 1d and 3d after intubation were significantly increased(PaO2:P=0.038;SpO2:P=0.041).However,arterial carbon dioxide pressure (PaCO2),heart rate (HR),respiratory rate (RR) and intracranial pressure were significantly decreased in both groups (PaCO2:P=0.033;HR:P=0.036;RR:P=0.044).The levels of PaO2 and SpO2 in the early intubation group at 1d and 3d after intubation were higher than those in the delayed intubation group (PaO2 at 1d after intubation:P=0.027,SpO2:P=0.028;PaO2 at 3d after intubation:P=0.017,SpO2:P=0.031).However,the levels of PaCO2,HR,RR and intracranial pressure were decreased (PaCO2 at 1d after intubation:P=0.036,HR:P=0.034,RR:P=0.023;PaCO2 at 3d after intubation:P=0.022,HR:P=0.030,RR:P=0.026).Compared with the delayed intubation group,the incidence of pulmonary infection and mortality were significantly lower in the early intubation group (the incidence rate of pulmonary infection:P=0.038;mortality rate:P=0.026).The proportion of level I and Ⅱ in ADL grade was significantly higher in the early intubation group than in the delayed intubation group,but level Ⅲ,Ⅳ and Ⅴ was significantly lower (P=0.024).Conclusion Early endotracheal intubation can effectively improve the clinical efficacy and prognosis in patients with acute severe craniocerebral injury,reducing its morbidity and mortality,which has important clinical significance,worthy of clinical use and promotion.
Keywords：traumatic brain injuryendotracheal intubationearlydelayedprognosis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 181-184 )