Application of Sequential Management of Airway Tubes in Reducing Tracheotomy Rate of Patients with Severe Neurological Diseases

OU Zhiying; DENG Chuangzhi; MENG Bing

doi:10.3969/j.issn.1672-7185.2023.10.014

Abstract：Objective To observe the effect of sequential management of airway tubes on reducing tracheotomy rate in patients with severe neurological diseases.Methods A retrospective study was conducted on 100 patients with severe neurological diseases admitted to Department of Neurosurgery,Dongguan Shipai Hospital,from June 2020 to December 2022.Among them,50 patients admitted from June 2020 to June 2021 were included in the control group,which was intervened with traditional management methods,and the other 50 patients admitted from July 2021 to December 2022 were included in the observation group,which was intervened with sequential management of airway tubes.The tracheotomy rate,incidence of airway safety events(airway obstruction and asphyxia,pulmonary infection,ventilator associated pneumonia),recovery time of oral swallowing,retention time of tracheal intubation,and incidence of late airway stenosis were compared between the two groups.Results The tracheotomy rate and late airway stenosis rate in the observation group were 16.00%and 0,respectively,which were significantly lower than those in the control group(74.00%and 10.00%,P<0.05).The incidences of airway obstruction and asphyxia,pulmonary infection,and ventilator associated pneumonia in the observation group were 2.00%,70.00%,and 60.00%,respectively,which were not significantly different with 0,78.00%,and 72.00%in the control group(P>0.05).There was no significant difference in airway safety between the observation group and the control group(P>0.05).The recovery time of oral swallowing(2.12±0.45)months and the retention time of tracheal intubation(1.02±0.23)months in the observation group were significantly shorter than those in the control group[(7.23±1.12)months and(9.74±1.47)months](P<0.05).Conclusion The sequential management method of airway tubes can reduce the tracheotomy rate of critically ill patients in neurosurgery,ensure airway safety,reduce long-term tracheal stenosis rate,shorten airway intubation retention time,and promote the recovery of swallowing function and early oral feeding.