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目的探讨下颌前托法开放气道配合喉罩通气在颈椎损伤院前急救中的应用效果。方法对2009年8月至2011年12月石家庄市井陉矿区医院收治的128例颈椎损伤患者相关资料进行分析,根据不同治疗方法将患者分为对照组和实验组,对照组采用常规气管插管方法进行通气治疗,实验组采用下颌前托法开放气道治疗,比较两组疗效。结果实验组93.8%对治疗方案疗效显著,明显优于对照组(疗效有效率为81.3%)(P<0.05);实验组93.8%对方案疗效满意,显著高于对照组(满意率达到65.6%)(P<0.05);实验组(喉罩组)与对照组(气管插管组)在置管成功率、平均置管时间、对颈椎的二次损伤和气道损伤方面均优于气管插管组(P<0.05);喉罩组与气管插管组通气效果差异不显著(P>0.05);实验组ADL评分为(16.2±3.7)分,颈椎功能评分为(59.6±7.5)分,心理功能评分为(65.8±9.2)分,社会功能评分为(57.2±6.5)分,均高于对照组(P<0.05)。结论颈椎损伤患者治疗过程中采用下颌前托法开放气道配合喉罩通气治疗效果理想,值得推广使用。
Objective To investigate the effect of open mandibular anterior approach combined with laryngeal mask ventilation on prehospital emergency care for patients with cervical spine injury. Methods A total of 128 patients with cervical spine injuries admitted to Jingjing Mining Hospital in Shijiazhuang from August 2009 to December 2011 were analyzed. The patients were divided into control group and experimental group according to different treatment methods. The control group was treated by conventional tracheal intubation Ventilation was performed. The experimental group was treated with open mandibular mandibular approach, and the curative effect was compared between the two groups. Results 93.8% of the experimental group was significantly better than the control group (effective rate was 81.3%) (P <0.05); 93.8% of the experimental group was satisfied with the treatment effect, significantly higher than the control group (satisfaction rate 65.6% ) (P <0.05). The experimental group (laryngeal mask group) and the control group (tracheal intubation group) were superior to tracheal intubation in success rate of catheterization, average catheterization time, secondary injury of cervical spine and airway injury (P <0.05). There was no significant difference in ventilation between laryngeal mask group and endotracheal intubation group (P> 0.05). ADL score was (16.2 ± 3.7) and cervical function score was (59.6 ± 7.5) The functional score was (65.8 ± 9.2) points, and the social function score was (57.2 ± 6.5) points, both higher than the control group (P <0.05). Conclusion The treatment of cervical spine injury patients with mandibular anterior approach open airway laryngeal mask ventilation with good results, it is worth promoting the use of.