Abstract: Objective  To study the clinical effects of early oropharyngeal ventilation tube or nasopharyngeal ventilation tube in patients with severe stroke. 
Methods  The consecutive patients with severe stroke admitted to the emergency room of Beijing Tiantan Hospital, Capital Medical University from June 2020 to June 2022 were included in the study. Patients were divided into oropharyngeal airway group, nasopharyngeal airway group and control group according to the use of oropharyngeal airway, nasopharyngeal airway, and non-use of oral/nasopharyngeal airway. Their clinical data were collected. The clinical features, incidence of pulmonary infection within 7 days after admission, conversion rate and time of sequent tracheal intubation were compared among all groups. 
Results  A total of 213 patients with severe stroke were included, including 123 males (57.7%), 119 cases of cerebral hemorrhage and 94 cases of cerebral infarction. There were 68 cases in oropharyngeal airway group, 79 cases in nasopharyngeal airway group, and 66 cases in control group. The incidence of aspiration in nasopharyngeal airway group was lower than that in the control group (10.13% vs. 19.70%, P=0.034) and oropharyngeal airway group (10.13% vs. 22.06%, P=0.021). The incidence of pulmonary infection within 7 days after admission in nasopharyngeal airway group was lower than that in control group (32.91% vs. 59.09%, P=0.018) and oropharyngeal airway group (32.91% vs. 45.59%, P=0.023). There was no statistical difference in in-hospital all-cause mortality (30.38% vs. 32.35% vs. 34.84%, P=0.660) among the three groups within 7 days after admission. The conversion rate of endotracheal intubation in nasopharyngeal airway group was lower than that in oropharyngeal airway group (12.66% vs. 44.12% P=0.022) and control group (12.66% vs. 43.94%, P=0.031). The conversion time of endotracheal intubation in nasopharyngeal airway group delayed compared to that in oropharyngeal airway group [(6.72± 2.15) d vs. (4.12±1.23) d, P=0.022] and control group [(6.72±2.15) d vs. (3.12±1.33) d, P=0.011]. Blood gas analysis at 7 days after admission showed that the blood oxygen partial pressure of nasopharyngeal airway group [(83.56±8.31) mmHg vs. (76.34±8.63) mmHg, P=0.007] and oropharyngeal airway group [(84.56±5.84) mmHg vs. (76.34±8.63) mmHg, P=0.003] was higher than that of the control group, while the carbon dioxide partial pressure of nasopharyngeal airway group [(37.67±11.22) mmHg vs. (48.56±9.62) mmHg, P=0.012] and oropharyngeal airway group [(36.45±17.53) mmHg vs. (48.56±9.62) mmHg, P=0.009] was lower than that in control group. 
Conclusions  In the early stage of severe stroke, oropharyngeal ventilation tube or nasopharyngeal ventilation tube can improve airway obstruction, increase blood oxygen partial pressure and reduce carbon dioxide retention. However, compared with oropharyngeal ventilation tube, nasopharyngeal ventilation tube can reduce the occurrence of aspiration after stroke, reduce the risk of pulmonary infection, delay the conversion time of endotracheal intubation, reduce the conversion rate of endotracheal intubation, and shorten the length of hospital stay. 

Key words: Severe stroke; Tracheal intubation; Oropharyngeal ventilation tube; Nasopharyngeal ventilation tube 

摘要：

关键词:   重症卒中；气管插管；口咽通气管；鼻咽通气管