急诊内快速顺序插管在脑外伤及脑卒中患者中的应用  

Study of Rapid Sequence Intubation for the Traumatic Brain Injury and Stroke Patients in Emergency

作　　者：叶镱[1] 关紫云[1] 蔡阳林[1] 周丽英[1] 陈瑞敏[1] 

机构地区：[1]广东省佛山市南海区人民医院急诊科,广东佛山528200

出　　处：《河北医学》2013年第10期1498-1501,共4页Hebei Medicine

摘　　要：目的:观察快速顺序插管(RSI)技术在脑外伤及脑卒中患者急诊气管插管中的临床应用效果。方法:98例脑外伤及脑卒中符合研究入选标准的患者,根据随机数字表随机分成试验组、对照组各49例,试验组行RSI,对照组行部分镇静表面麻醉下经口气管内插管,观察记录喉部显露的C/L(Cormack-Lehane)分级、插管时间、插管次数、血压变化、心率变化、SPO2的最低下降值及并发症;计算IDS评分及比较总体有效率。结果:两组插管时间试验组(20.05±5.50)s比对照组(31.58±9.34)s短,差异有统计学意义(P<0.05);试验组声门显露的C/L分级、插管次数、插管过程中收缩压、心率波动及SPO2的最低下降值均显著优于对照组(P<0.01);试验组并发症发生率低,其IDS评分及总体有效率(93.87%)显著优于对照组(p<0.01)。结论:RSI应用于脑外伤及脑卒中患者急诊气管插管安全迅速有效,对比部分镇静表面麻醉下经口气管内插管有明显优势,值得临床推广。Objective： To evaluate the value of rapid sequence intubation（RSI） for the traumatic brain injury and stroke patients in emergency.Method： 98 patients meet the criteria with traumatic brain injury and stroke,were randomly divided into two groups： the test group（RSI for orotracheal intubation,n = 49） and the control group（part sedation and surface anesthesia for orotracheal intubation,n = 49）,Observed and recorded C / L（Cormack-Lehane） grade,the time taken for successful intubation,tracheal intubation times,changes in systolic blood pressure,changes in heart rate,lowest SPO2 during the intubation and complications;IDS（intubation difficulty score） scores were calculated and the total effective rate were compared.Result： The data showed that there＇s significant differences in the duration of the successful endotracheal intubation attempts between the two groups,respectively（20.05 ± 5.50） s and（31.58 ± 9.34） s,P 0.05;The C / L grade,tracheal intubation times,changes in systolic blood pressure,changes in heart rate and the lowest SPO2 during the intubation of the test group were significantly better than that of the control group（P 0.01）.The incidence of complications was lower in the test group,The IDS score and the total effectice rates（93.87%） of the test group were significantly better than that of the control group（p 0.01）.Conclusion： Using RSI in emergency endotracheal intubation for the traumatic brain injury and stroke patients is safe,quick and effective,It has obviously advantages than the part sedation and surface anesthesia for orotracheal intubation,It is worthy of promotion.

关 键 词：快速顺序气管插管 脑卒中 脑外伤 

分 类 号：R614[医药卫生—麻醉学]