喉罩和视频喉镜在颈椎损伤患者院前急救气道开放中的应用效果及学习曲线比较  

Comparison of application effect and learning curve for airway establishment in patients with cervical spine injury during pre-hospital first aid between laryngeal mask and video laryngoscope

作　　者：杜庆[1] 张胜楠[2] 姜婕[1] 李蕾[1] 马驰骋[1] 

机构地区：[1]山东省济南市第四人民医院急诊科,济南市250012 [2]山东省济南市口腔医院,济南市250001

出　　处：《广西医学》2017年第12期1834-1836,1840,共4页Guangxi Medical Journal

摘　　要：目的比较应用喉罩和视频喉镜在颈椎损伤患者院前急救开放气道中的应用效果及学习曲线。方法将20名内科医师分成喉罩组和视频喉镜组各10名,分别使用喉罩、视频喉镜在颈椎损伤模拟人上进行院前急救气管插管培训,比较两组每次训练时建立有效通气所需尝试的次数和时间、有效通气成功率。用累积和计算方法绘制两组的学习曲线,计算最少操作例数。结果喉罩组的有效通气成功率为83.2%,高于视频喉镜的69.6%(P<0.05),喉罩组建立有效通气所需尝试的次数和时间均少于视频喉镜组(P<0.05)。视频喉镜组、喉罩组学习曲线的曲线斜率分别自24次、11次操作起为负值,学习曲线进入平台期。结论与视频喉镜比较,使用喉罩在颈椎损伤模拟患者上院前急救开放气道所需的时间短、成功率高,学习曲线更短,更容易被掌握,缩短了培训时间。Objective To compare the application effect and learning curve for airway establishment in patients with cervical spine injury during pre-hospital first aid between laryngeal mask and video laryngoscope. Methods Twenty internists were divided into laryngeal mask group and video laryngoscope group,with 10 internists in each group. The laryngeal mask group and the video laryngoscope group received the tracheal intubation training of pre-hospital first aid in manikins with cervical spine injury using laryngeal mask and video laryngoscope respectively. The attempts and procedure time for establishing effective ventilation during each training session,and success rate of effective ventilation were compared between the two groups. The learning curve was drawn using Cumulative Summation method in the two group,and the least times for successful tracheal intubation were counted. Results The success rate of effective ventilation in the laryngeal mask group was higher than that in the video laryngoscope group（ 83. 2% vs. 69. 6%; P〈0. 05）. The attempts and procedure time for establishing effective ventilation in the laryngeal mask group were less than those in the video laryngoscope group（ P〈0. 05）. The slopes of the learning curves turned to be negative at the 24 th and 11 th training session in the video laryngoscope group and the laryngeal mask group respectively,and then the curve kept at a steady state. Conclusion Compared to the video laryngoscope,the laryngeal mask applied to airway establishment in manikins with cervical spine injury during pre-hospital first aid requires less procedure time,can achieve a higher success rate and shorter learning curve,can be easily mastered and shorten the training time.

关 键 词：颈椎损伤 院前急救 视频喉镜 喉罩 学习曲线 模拟人 

分 类 号：R459.7[医药卫生—急诊医学]