双管喉罩对洗胃并发吸入性肺炎的预防作用  

The preventive effect of twin-tube laryngeal mask airway on gastric lavage and inhalation pneumonia in patients with toxic coma

作　　者：熊华威[1] 黄亮[1] 王昊[2] 廖玉龙 涂江涛 Xiong Huawei;Huang Liang;Wang Hao;Liao Yulong;Tu Jiangtao(Emergency Department,the First Affiliated Hospital of Nanchang University,Nanchang 330000,Chin;Intensive Medicine Department,the No.94th Hospital of Chinese PLR,Nanchang 330000,Chin;Intensive Medicine Department,Xinyu People＇s Hospital,Xinyu 338000,China)

机构地区：[1]南昌大学第一附属医院急诊科,南昌330000 [2]中国人民解放军第几四医院重症医学科,南昌330000 [3]新余市人民医院重症医学科,江西省新余338000

出　　处：《中华急诊医学杂志》2018年第9期1026-1029,共4页Chinese Journal of Emergency Medicine

基　　金：江西省卫生计生委科技计划（20155175）

摘　　要：目的探讨应用双管喉罩对洗胃并发吸入性肺炎的预防作用。方法采用前瞻性随机对照试验方法，收集2015年1月至2017年6月南昌大学第一附属医院急诊科抢救室收治的各类中毒昏迷患者305例，根据入选标准和排除标准，共选择255例进行入组进行研究。随机（随机数字法）将255例各类中毒昏迷患者分为3组，其中A组（常规机器洗胃法）85例，B组（洗胃之前先行气管插管）85例，C组（洗胃之前先行双管喉罩置入）85例。观察发病12h有无吸入性肺炎，并统计住院时间，住院费用，病死率。两样本均数比较采用成组t检验，四格表资料采用卡方检验，以P〈0．05为差异有统计学意义。结果与A组比较，B组、C组12h并发吸入性肺炎的发病率明显更低（A组：56．47％，B组32．94％，C组23．53％，P〈0．01）；与A组相比，C组住院时间缩短[（3．39±2．12）d vs．（6．06±4．91）d，P〈0．05]，住院费用降低[（25687．52±20803．44）元vs．（52213．91±37267．56）元，P〈0．05]；与B组比较，C组住院时间缩短[（3．39±2．12）d vs．（5．51±4．37）d，P〈0．05），住院费用降低[（25687．52±20803．44）元vs．（50887．82±32399．76）元，P〈0．01]；三组病死率差异无统计学意义（P〉0．05）。结论双管喉罩用于中毒昏迷患者的洗胃中，不仅能够保证有效通气，而且降低了并发吸人性肺炎的概率，缩短住院时间，降低住院费用，但对病死率无明显影响。Objective To explore the preventive effect of twin-tube laryngeal mask airway on gastric lavage and aspiration pneumonia. Methods Between January 2015 and June 2017, 305 cases of poisoning coma patients were admitted to Emergency Department, The First Affiliated Hospital of Nanchang University. According to the inclusion criteria and exclusion criteria, 255 cases of poisoning coma patients were enrolled and randomly（random number） divided into 3 groups （n=85 in each group）： group A （normal gastric lavage machine method）, group B （gastric lavage endotracheal intubation）, and group C （gastric lavage twin-tube laryngeal mask airway placement）. Whether there was aspiration pneumonia within 12 hours after the onset was observed, and the length of hospital stay, hospitalization cost and mortality were recorded. The mean value of the two samples was compared with t test, and the four-grid data were checked by chi-square test. P〈0.05 was statistically significant. Results Compared with group A, the incidence of aspiration pneumonia was significantly lower in group B and group C （group A 56.47%, group B 32.94%, group C 23.53%, P〈0.01）. Compared with group A, the length of hospital stay in group C was shorter [（3.39± 2.12） d vs. （6.06 ± 4.91） d, P〈0.05], and the hospitalization cost was less [（25 687.52 ± 20 803.44） yuan vs. （52 213.91± 37 267.56）yuan, P〈0.05]. There was no significant difference of mortality between the three groups （P〉0.05）.Compared with group B, the length of hospital stay in group C was shorter [（3.39 ± 2.12） d vs. （5.51 ± 4.37） d, P〈0.05], and the hospitalization cost was less [（25 687.52 ±20 803.44）yuan vs. （50 887.82 ± 32 399.76） yuan, P〈0.05]. There was no significant difference of mortality between the three groups （P〉0.05）. Conclusions Twin-tube laryngeal mask airway for poisoning coma patients with gastric lavage, can not only ensures effective ventilation, but also reduces the probability of concurrent asp

关 键 词：双管喉罩 中毒 昏迷 洗胃 吸入性肺炎 

分 类 号：R595[医药卫生—内科学] R563.1[医药卫生—临床医学]