美迪醫(yī)療網(wǎng)成揚(yáng)報(bào)道說，最近一項(xiàng)研究顯示：在外傷程度相似的情況下，如果腦外傷患者在事故現(xiàn)場接受了緊急氣管插管，他們的預(yù)后比那些在送抵醫(yī)院后接受插管的患者要差。2004年11月份的《急診醫(yī)學(xué)年報(bào)》(Annals of Emergency Medicine)報(bào)道了這項(xiàng)研究成果。

盡管院外氣管插管是一項(xiàng)試圖挽救生命的有價(jià)值干預(yù)手段，較早期的研究提示這種快速干預(yù)造成的不利后果大于有利后果。現(xiàn)在，匹茲堡大學(xué)(PA, USA)的研究人員對(duì)一項(xiàng)回顧性分析研究做出了結(jié)論，研究資料來自2000年～2002年的賓夕法尼亞外傷預(yù)后研究項(xiàng)目，研究對(duì)象是嚴(yán)重頭部外傷的成年患者。

絕大多數(shù)此類患者的基本預(yù)后是死亡，其次是不同類型的神經(jīng)性和功能性損害。在4,098例插管患者中，那些在院外接受插管的患者死亡比例要高4倍多。神經(jīng)性和功能性損害比例同樣高出許多。

“輔助醫(yī)務(wù)人員，盡管接受過良好培訓(xùn)，但是他們實(shí)踐的機(jī)會(huì)并不多。他們必須在極其困難的環(huán)境下完成操作，并且得不到在醫(yī)院里能夠獲得的許多幫助，”匹茲堡大學(xué)醫(yī)學(xué)院急診科副主任、教授Donald M. Yealy醫(yī)學(xué)博士這樣評(píng)論，他也是此文作者之一。“也許這些研究成果提示我們應(yīng)該重新評(píng)介如何處理此類患者。”研究人員指出仍然需要進(jìn)一步深入研究。

Value of Pre-Hospital Intubation Questioned
 
A study has shown that patients with similar traumatic brain injuries who receive an emergency breathing tube at the scene of an accident have worse outcomes than those who are intubated after arrival at the hospital. The findings were reported in the November 2004 issue of Annals of Emergency Medicine.

While out-of-hospital intubation can be a valuable interventional tool in helping to save lives, earlier studies had suggested that this rapid intervention may be more harmful than helpful. Now, researchers at the University of Pittsburgh (PA, USA) have conducted a retrospective analysis using data obtained from the Pennsylvania Trauma Outcome study between 2000 and 2002, and studied adult patients with severe head injuries.

The primary outcome for most of these patients was death, with secondary outcomes being various types of neurologic and functional impairment. Among the 4,098 patients who were intubated, the odds of death were about four times greater if they were intubated out of the hospital. Neurologic and functional impairment were also greater.

“Paramedics, while very well trained, don’t often have opportunity to perform this procedure, and must attempt it in a difficult environment and without many of the aids available in the hospital,” said Donald M. Yealy, M.D., professor and vice chairman of the department of emergency medicine at the University of Pittsburgh School of Medicine and one of the study’s authors. “Perhaps these findings indicate that we need to reassess how we manage these cases.” The researchers note that additional studies are needed.