摘要
目的:比较研究重症监护病房(ICU)急性脑血管意外昏迷患者心肺复苏中呼吸机管理及使用喉罩与气管插管的技术策略。方法:选取ICU中60例急性脑梗塞昏迷进行心肺复苏患者,按数字表法随机将其分为观察组与对照组,每组30例。观察组患者心肺复苏中使用喉罩;对照组患者心肺复苏中使用气管插管,比较两组患者的临床效果。结果:治疗后观察组插管所需时间为(11.2±8.0)s,对照组为(67.8±13.7)s,两组相比存在差异(t=4.32,P<0.05);观察组复苏成功20例(占66.7%),一次性插管成功29例(占96.7%),对照组复苏成功11例(占36.7%),一次性插管成功20例(占66.7%),观察组明显优于对照组,两组相比差异显著(x^2=1.87,x^2=0.56;P<0.05);观察组患者缺氧症状缓解或解除所用时间为(4.3±0.8)min,对照组为(7.2±0.7)min,两组相比差异较大(t=7.528,P<0.05)。24 h后,两组患者血浆脑钠肽浓度及肺动脉压力均明显下降,观察组较对照组血浆脑钠肽浓度及肺动脉压力下降显著。结论:喉罩在急诊心肺复苏抢救过程中,能有效缩短插管时间,增加插管的成功率,从而提高患者的存活率,值得临床推广与应用。
Objective：To compare the technical strategies of endotracheal intubation and larynx mask for cardiopulmonary resuscitation with ventilator management on patients with acute cerebral infarction coma in EICU. Methods： 60 cases of EICU in acute cerebral infarction coma patients with cardiopulmonary resuscitation were randomly divided into observation group and control group with 30 cases in each group. Patients in the control group were examined by endotracheal intubation during cardiopulmonary resuscitation and patients in the observation group by the laryngeal mask. The clinical effects of two groups of patients were compared.Results： The time required for intubation of observation group after treatment was （11.2±8.0）s and the control group was （67.8±13.7）s. There were differences between the two groups （t=4.32,P〈0.05）. There were 20 cases of successful resuscitation and 29 cases of one-time intubation success in the observation group. And there were 11 cases of successful resuscitation and 20 cases of one-time intubation success in the control group. The observation group was obviously better than the control group, and the difference was statistically significant （x2=1.87,x2=0.56;P〈0.05）. The time that patients with symptoms of hypoxia alleviate or remove was （4.3＋0.8）min in the observation group and （7.2＋0.7）min in the control group. The differences were statistically significant （t=7.528,P〈0.05）. With the first aid nursing after 24h, two groups of patients with plasma brain natriuretic peptide concentration and pulmonary artery pressure decreased significantly. Compared with the control group, plasma brain natriuretic peptide concentration and pulmonary arterial pressure in the observation group decreased significantly.Conclusion： The laryngeal mask in rescuing with emergency cardiopulmonary resuscitation, can effectively shorten the intubation time, increase intubation success rate, so as to improve the survival rate of the patients. It is worthy of clinical promotion and application.
出处
《中国医学装备》
2016年第6期72-75,共4页
China Medical Equipment
关键词
心肺复苏
喉罩
气管插管
急性脑血管意外昏迷
临床效果
Cardiopulmonary resuscitation
Laryngeal mask
Endotracheal intubation
Acute cerebral infarction coma
Clinical effect
