ARDS高危患者气管插管中可视喉镜联合PETCO2应用对救治质量影响  

The effect of visual laryngoscope combined with PETCO2 application on the quality of treatment in high-risk ARDS patients with tracheal intubation

作　　者：许艳[1] 杜叶平[1] 贾素红[1] 李倩[1] 肖春玲[1] XU Yan;DU Ye-ping;JIA Su-hong;LI Qian;XIAO Chun-ling(Emergency Department,Huai'an Second People's Hospital,Jiangsu Huaian 223002,China)

机构地区：[1]淮安市第二人民医院急诊科,江苏淮安223002

出　　处：《临床医药文献电子杂志》2020年第76期3-5,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨和评价急性呼吸窘迫综合征(ARDS)高危患者气管插管中可视喉镜联合呼气末二氧化碳监测(PETCO2)应用对救治质量的影响。方法选取我院2017年1月~2020年7月间68例应用可视喉镜进行气管插管后行机械通气治疗的ARDS高危患者,其中联合应用听诊器的32例患者为A组,另外36例联合应用PETCO2的患者作为B组。对比两组患者一次性气管插管成功率、判断导管位置正确率、判断导管在位时间、血气分析结果及疗效。结果B组患者一次性气管插管成功率、判断导管位置正确率明显高于A组(x2=6.364,6.57,P=0.012,0.01,均P<0.05);B组判断导管在位时间及气管插管所用时间较A组均明显缩短(t=19.5821,50.9894,均P<0.01);两组插管前及插管成功后血气分析结果中PaO2、PaCO2、氧合指数(PaO2/FiO2)差异不明显(均P>0.05);A组插管后机械通气时间为(6.57±1.65)d,病死5例(1.56%);B组插管后机械通气时间为(7.12±1.83)d,病死6例(1.67%),A、B组插管后机械通气时间及总体病死率比较无统计学差异(t=0.6915,x2=0.014,均P>0.05)。结论可视喉镜联合PETCO2应用于ARDS高危患者气管插管机械通气治疗中,可明显提高患者气管插管成功率、判断导管位置正确率,该方法临床应用方便可行,早期应用效果佳。Objective To explore and evaluate the impact of visual laryngoscope combined with end-expiratory carbon dioxide monitoring(PETCO2)on the quality of treatment in high-risk patients with acute respiratory distress syndrome(ARDS).Methods From January 2017 to July 2020,68 patients with high-risk ARDS who underwent mechanical ventilation after tracheal intubation with visual laryngoscope were selected in our hospital.Among them,32 patients who were combined with stethoscope were classified as group A,and the other 36 were combined Patients with PETCO2 were treated as group B.The success rate of one-time tracheal intubation,the correct rate of judging the catheter position,the judging time of the catheter in place,the results of blood gas analysis and the curative effect of the two groups were compared..Results The success rate of one-time tracheal intubation and the correct rate of judging the position of the catheter in group B were significantly higher than those in group A(x2=6.364,6.57,P=0.012,0.01,all P<0.05);group B was able to judge the catheter in-position time and tracheal intubation The time spent on the tube was significantly shorter than that of group A(t=19.5821,50.9894,both P<0.01);there was no difference in PaO2,PaCO2,and oxygenation index(PaO2/FiO2)in blood gas analysis results before and after successful intubation between the two groups Significantly(all P>0.05);the mechanical ventilation time after intubation in group A was(6.57±1.65)days,and 5 cases died(1.56%);the mechanical ventilation time after intubation in group B was(7.12±1.83)days,Six patients died(1.67%).There was no significant difference in the mechanical ventilation time after intubation and overall mortality in groups A and B(t=0.6915,x2=0.014,both P>0.05).Conclusion Visual laryngoscopy combined with PETCO2 in the treatment of mechanical ventilation for tracheal intubation in high-risk ARDS patients can significantly improve the success rate of tracheal intubation and the correct rate of judging the catheter position.This method is c

关 键 词：ARDS 气管插管 可视喉镜 二氧化碳检测 肺循环 血气分析 

分 类 号：R459.7[医药卫生—急诊医学]