双管喉罩与气管插管在急救复苏中的应用比较  

Comparison of proseal laryngeal mask airway and tracheal intubation in emergent resuscitation

作　　者：仇威富[1] 王金树 

机构地区：[1]香港大学深圳医院急诊科,广东深圳518053 [2]广东省深圳市西丽人民医院重症医学科,广东深圳518055

出　　处：《中国医药导报》2015年第10期86-89,共4页China Medical Herald

基　　金：广东省深圳市科技计划项目(医疗卫生类)(编号201203241)

摘　　要：目的比较双管喉罩与气管插管在急救复苏中的应用效果。方法回顾性分析2011年6月~2013年5月于深圳市西丽人民医院接受急救治疗的50例成年患者的临床资料,其中24例采用双管喉罩为研究组,26例采用气管插管为对照组。比较两组患者的插管耗时、插管次数及插管前、插管即刻、插管后1、5、10 min和拔管即刻患者的心率及血压情况,比较两组呼吸道损伤以及呼吸系统并发症。结果所有患者均插管成功,研究组一次成功20例,二次成功4例;对照组一次成功23例,二次成功3例。研究组平均耗时（24.9±10.4）s,对照组平均耗时（24.0±11.5）s。两组患者插管一次成功率以及平均耗时比较差异均无统计学意义（P〉0.05）。插管成功患者血氧饱和度均维持在95%~100%。所有患者均放置胃管成功,两组患者均没有发生误吸、胃胀气、漏气、呼吸道梗阻、咽喉部损伤等情况。两组患者在插管即刻及拔管即刻血压、心率均有显著升高（P〈0.01）;但对照组变化更为明显,其在插管即刻、插管后1 min及拔管即刻的收缩压、舒张压及心率均显著高于研究组（P〈0.01）。结论双管喉罩用于临床急救复苏,血液动力学的影响相对较小。Objective To compare the application effect of proseal laryngeal mask airway（PLMA） and tracheal intubation（TI） in emergent resuscitation.Methods Clinical data of 50 adult patients received emergent resuscitation from June 2011 to May 2013 in Xili People＇s Hospital of Shenzhen were retrospectively analyzed.24 cases of study group were given PLMA,and 26 cases of control group were given TI.Intubation time consuming,intubation times,heart rate and blood pressure before intubation,and the moment of intubation,1 minute after intubation,5 minutes after intubation,10 minutes after intubation and the moment of extubation of two groups,respiratory damage and respiratory complications were compared.Results All patients were successfully intubated,disposable successful intubation of study group was 20 cases,and secondary success 4 cases.Disposable successful intubation of the control group was 23 cases,and 3 cases was secondary success.Intubation time consuming of the study group was（24.9±10.4） s,which of the control group was（24.0±11.5） s.One-time success rate and intubation times of two groups showed no significant difference（P〈0.05）.Sa O2 of all patients were 95%-100%.Gastric tube placement of all patients were successful.No cases with aspiration,gaseous distention,air leak,airway obstruction and throat damage of two groups.Blood pressure and heart rates at the moment of intubation and extubation of two groups increased apparently（P〈0.01）;blood pressure and heart rates of control group at the moment of intubation,1 minute after intubation and the moment of extubation were higher than those of the study group（P〈0.01）.Conclusion The impact to haemodynamics is relatively small with the using of PLMA for clinical emergent resuscitation.

关 键 词：双管喉罩 气管插管 急救复苏 

分 类 号：R605.97[医药卫生—急诊医学]