序贯性气道开放在急诊心肺复苏中应用探讨  

Exploration of sequential airway opening during emergency cardiopulmonary resuscitation

作　　者：刘江华[1] 雷卓青[1] 

机构地区：[1]广西医科大学第一附属医院西院急诊科,广西南宁530007

出　　处：《华夏医学》2009年第2期197-200,共4页Acta Medicinae Sinica

摘　　要：目的:为紧急心肺复苏(CPR)探索一条更快捷、更有效、更易推广普及的气道开放方法,以提高CPR的成功率及存活率。方法:选择心跳、呼吸骤停需紧急心肺复苏的患者110例,随机分为序贯性气道开放实施A组(面罩气囊口咽通气管-气管插管组)、B组(喉罩-气管插管组)和常规气管插管C组,比较三组在心肺脑复苏急救中的实施时效性、复苏成功率、并发症及存活率。结果:①实施组A组、B组一次性置管成功率高于C组(P<0.05),有显著性差异;A组、B组反复气管插管次数少于C组(P<0.05),有显著性差异;A组、B组插管所需时间、气道有效开放时间均短于C组(P<0.01),有显著性差异。②实施A组、B组的复苏成功率高于C组(P<0.05),有显著性差异;复苏期间A组、B组的瞳孔由大变小时间、自主呼吸恢复时间、SpO2上升时间均短于C组(P<0.05、P<0.01),有显著性差异。③B组胃内容物误吸率高,与C组比较有显著性差异(P<0.05),A组、B组咽部损伤率低于C组,有显著性差异(P<0.01)。腹胀、肺部感染率三组之间无显著性差异;A组、B组存活率高,与C组比较有显著性差异(P<0.05)。结论:序贯性气道开放能及时、有效、可靠地早期开放气道,能更合理地协调与胸外按压的交互性,提高CPR复苏成功率和存活率,适合在CPR中普及推广;而面罩气囊口咽通气管和喉罩在序贯性气道开放术中能达到相同的效果。Objective：To use valid airway opening in order to improve the successful rate and survival rate of CPR. Methods： 110 patients with cardiopulmonary sudden were randomly divided into 3 groups： A group （mask mouth- pharynx airway-tracheal intubation group）, B group（laryngeal mask airway-tracheal intubation group）and normal C group（tracheal intubation group）. The effectiveness,successful rate, complications and survival rate of CPR were compared in three groups. Results ：（1）Compared with C group, successful rate of intubation was higher, frequency of intubation was lower,time of intubation and time of airway opening was shorter in A or B group. The differences were significant. （2）Compared with C group, successful rate of CPR was higher, time of pupil change, spontaneous circulation recovery and SpO2 rising was shorter in A or B group. The differences were significant. （3）missucking rate of B group was higher than that of C group; injured pharynx rate of A or B group was lower than of that C group, abdominal distension and lungs infection rate in three groups was no differences. Conclusion： Sequential airway opening can open the airway in time, effectively and reliably. It can harmonize with closed cardiac massage, increase successful rate and the survival rate of CPR. The mask mouth-pharynx airway and laryngeal mask airway have the same effect.

关 键 词：面罩气囊口咽通气管 喉罩 气管插管 序贯性气道开放 心肺复苏 

分 类 号：R459.7[医药卫生—急诊医学]