喉罩通气在院前心肺复苏中的临床研究  

A Clinical Study of Laryngeal Mask Airway Application During Cardiopulmonary Resuscitation

作　　者：张剑峰[1] 李荣杰[1] 赵德明[1] 莫俊强[1] 黄志文[1] 梁棕[1] 

机构地区：[1]广东省江门市新会人民医院急诊科,529100

出　　处：《岭南急诊医学杂志》2006年第1期10-11,15,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨院前心肺复苏(CPR)时早期盲插喉罩通气对复苏成功率的影响。方法:对院前发生心跳呼吸骤停患者460例,根据CPR时对患者建立人工气道的不同措施将其分为3组,A组210例,常规CPR时即盲插喉罩通气;B组40例,常规CPR时即行气管内插管;C组210例,常规CPR时以球囊面罩装置通气,转送至急诊科再行气管内插管,插管延迟时间5～15min。结果:插管所需时间:A组10.4±7.5s;B组96±25.7s;C组52±27.5s;3组相比差异有显著性(P<0.001)。一次插管成功率:A组盲探下插入喉罩全部1次成功,成功率100%;B组插管1次成功28例,2次成功9例,3次以上3例,一次插管成功率70%;C组插管1次成功200例,2次成功10例,一次插管成功率95.2%;3组相比差异有显著性(P<0.01)。复苏成功率:A组复苏成功41例,成功率19.5%;B组复苏成功1例,成功率2.5.%;C组复苏成功8例,成功率3.8%;A组与B、C组复苏成功率比较差异有显著性(P<0.01),B组与C组复苏成功率比较差异无显著性(P>0.05)。结论:在院前心肺复苏时,早期盲插喉罩通气具有操作快捷,可盲探插管且成功率高,能明显提高抢救成功率,而早期气管插管需时长,一次插管成功率较低,不能提高CPR成功率。Objective： To study the effect of early laryngeal mask airway （LMA） using the blind insertion approach during cardiopulmonary resuscitation （CPR）. Method： 460 patients with cardiac arrest during pre-hospital were reviewed and were divided into three groups according to the measures to provide artificial airway. Group A, 210 cases, were given blind inserted LMA as soon as routine PCR began; Group B, 40 cases, were given cndotracheal intubation （ETT） as soon as routine PCR began; Group C, 210 cases, were given bag-mask ventilation when routine PCR began, ETr were provided after patients were transported to emergency department, intubations were delayed for 5-10 min. Results： The times for intubation were 10.4±7.5s for group A, 96±25.7 s for group B, 52±27. 5s for group C. There were significant difference among three groups （P〈0.01）. The successful rates of first intubations were 100% for group A, 70% for group B, 95.2% for group C. There were significant difference among three groups （P〈0.01）. Resuscitation success were 41 cases （19.5%） for group A,1 case（2.5%） for group B, 8 cases（3.8%） for group C, there were significant difference between group A and group B or C （P〈0.01）. There was no difference between group B and group C （P〉0.05）. Conclusions： Early LMA can provide an effective airway during pre-hospital PCR, can be blind inserted and achieved faster and easily. The resuscitation successful rate was significantly improved. Early ETr need more time and has a low successful rate of first intubations, which was harmful for CPR success.

关 键 词：早期 喉罩 气管插管 心跳呼吸骤停 心肺复苏 成功率 

分 类 号：R459.7[医药卫生—急诊医学]