紧急气管插管在特殊情况心肺复苏中的临床应用  

Clinical Application of Emergent Tracheal Intubation in Special Cases of Cardiopulmonary Resuscitation

作　　者：张剑峰[1] 黄志文[1] 刘华耀 梁俊杰[1] 梁棕[1] 吕博文[1] 

机构地区：[1]广东省江门市新会区人民医院急诊科,529100

出　　处：《岭南急诊医学杂志》2010年第6期443-444,467,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨紧急气管插管在重型颅脑外伤、中毒、淹溺、自缢、异物窒息等特殊情况下院前心肺复苏(CPR)中临床应用的必要性、可行性,以提高急救水平。方法:对院前因重型颅脑外伤、中毒、淹溺、自缢、异物窒息等特殊情况导致心跳呼吸骤停患者48例根据CPR时先行建立人工气道的不同措施将其分为两组,院前CPR时先行紧急气管插管(A组,n=40);院前CPR时先行盲探置入喉罩(B组,n=8)。结果:A组现场发现不同程度气道阻塞31例,全部插管成功,插管时间均少于2 min,通气良好,复苏成功28例;B组现场先行盲探置入喉罩,但通气不良,均改行紧急气管插管,发现8例均有不同程度气道阻塞,全部插管成功,插管时间均少于2 min,通气良好,复苏成功2例;A组复苏成功率明显高于B组(P<0.05)。结论:在重型颅脑外伤、中毒、淹溺、自缢、异物窒息等特殊情况下院前心肺复苏抢救中,紧急气管插管仍是无可替代的建立人工气道首选方法。Objective： To explore the necessity and possibility of emergent tracheal intubation in special cases of prehospital cardiopnlmonary resuscitation （CPR） such sa severe craniocerebral trauma, intoxication, drowning, foreign matter asphyxia etc. and to raise the level of first aid. Methods： 48 cases of prehospital CPR for cardiopulmonary arrests caused by the special circumstances were divided into group A （n=40）and group B（n=8）. Emergent tracheal intuhation was applied firstly in prehospital CPR in group A and blind layrngeal mask airway firstly in group B. Results： 31 cases with different extent of airway obstruction in the course of emergent tracheal intubations in group A,emergent tracheal intubation was applied successfully in all the cases of airway obstruction in less than 2 rains and achieved a good ventilation,and 28 cases of CPR succeeded. Blind layrngeal mask airway was applied firstly in group B,but ventilation was bad. Emergent tracheal intubation was applied later successfully in all the 8 cases in less than 2 rains,then achieved a good ventilation, but only 2 cases of CPR succeeded. The rate of CPR succeed was significantly higher in group A than that in group B （P〈O.05）. Conclusion： Emergent tracheal intubation is a non- replacile and favored preferred method of constructing artificial airway in the special cases of prehospital CPR such as severe craniocerebral trauma, intoxication, drowning, foreign matter asphyxia etc.

关 键 词：紧急气管插管 喉罩 气道阻塞 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]