经皮环甲膜穿刺置管院前急救治疗急性上呼吸道阻塞121例  

Clinical study on transcutaneous puncture catheterization of cricothyroid membrane in prehospital to treat patients with acute upper airway obstruction

作　　者：杨明[1] 田雪 李青[1] 于巧青 田雨 YANG Ming;TIAN Xue;LI Qing;YU Qiaoqing;Tian YU(Department of Emergency,Langfang People's Hospital,Langfang,Hebei,065000,China;Department of Critical Medicine,Langfang People's Hospital,Langfang,Hebei,065000,China;Department of Pediatrics,Langfang People's Hospital,Langfang,Hebei,065000,China;Department of Gynecology and Obstetrics,Langfang Hospital of Traditional Chinese Medicine,Langfang,Hebei,065000,China)

机构地区：[1]廊坊市人民医院急诊科,河北廊坊065000 [2]廊坊市人民医院重症医学科,河北廊坊065000 [3]廊坊市人民医院儿科,河北廊坊065000 [4]廊坊市中医医院妇产科,河北廊坊065000

出　　处：《安徽医药》2021年第5期992-995,共4页Anhui Medical and Pharmaceutical Journal

基　　金：廊坊市科学技术研究与发展计划(2016013011)。

摘　　要：目的探究经皮环甲膜穿刺置管在院前救治急性上呼吸道阻塞病人的临床效果。方法选取2006年5月至2016年5月廊坊市人民医院急性上呼吸道阻塞病人227例,其中采用经皮环甲膜穿刺置管治疗的病人121例,作为观察组,采用常规治疗(气管插管、环甲膜穿刺、面罩吸氧)的病人106例作为对照组。比较两组治疗情况、治疗效果、并发症发生率、治疗前后血气指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))]及病人对救治工作满意度。结果观察组建立气道时间少于对照组[(28.26±8.30)s比(40.19±11.54)s,P<0.05];观察组呼吸稳定时间[(29.51±8.19)s比(41.28±10.8)s]、呼吸困难改善时间[(37.62±10.35)s比(50.11±11.6)s]、呼吸稳定时间[(40.96±9.75)s比(58.23±11.2)s]、心率恢复正常时间[(2.35±0.86)min比(3.37±0.79)min]均短于对照组(P<0.05);观察组治疗后10 min、20 min PaO_(2)、SaO_(2)均高于对照组,PaCO_(2)低于对照组(P<0.05);观察组并发症发生率(16.53%)低于对照组(37.74%)(P<0.05);观察组对救治工作的总体满意度优于对照组,且观察组满意率明显高于对照组,差异均有统计学意义(P<0.05)。结论采用经皮环甲膜穿刺置管在院前救治急性上呼吸道阻塞病人,能显著缩短建立气道时间,降低创伤性,有效促进病人呼吸、心跳及血氧状况恢复,且并发症发生率低,病人对救治工作满意度高,是一种安全、高效的救治方法。Objective To explore the clinical effect of transcutaneous puncture catheterization of cricothyroid membrane in the prehospital treatment of patients with acute upper airway obstruction.Methods From May 2006 to May 2016,the clinical data of 227 patients in pre-hospital with acute upper airway obstruction in the Langfang People’s Hospital were selected and analyzed retrospectively,among them,121 patients were treated with transcutaneous puncture catheterization of cricothyroid membrane as the observation group,a total of 106 patients were treated with conventional treatment(tracheal intubation,cyclomembrane puncture,mask oxygen)as the control group.The treatment status,treatment effect,complication rate and blood gas index[arterial blood oxygen pressure(PaO_(2)),blood oxygen saturation(SaO_(2)),arterial blood carbon dioxide pressure(PaCO_(2))]before and after treatment,and patient satisfaction with treatment were compared between the two groups.Results The time to establish airway in the observation group was less than that in the control group((28.26±8.30)s vs.(40.19±11.54)s,P<0.05);the time of stable breathing[(29.51±8.19)s vs.(41.28±10.8)s],the time of improvement of dyspnea[(37.62±10.35)s vs.(50.11±11.6)s],the time of breathing stabilization[(40.96±9.75)s vs.(58.23±11.2)s],and the time of returning to normal heart rate[(2.35±0.86)min vs.(3.37±0.79)min]in the observation group were shorter than those in the control group(P<0.05);in the observation group,PaO_(2)and SaO_(2)were higher than those in the control group and PaCO_(2)was lower than those in the control group at 10 and 20 minutes after treatment(P<0.05);the incidence of complications in the observation group(16.53%)was lower than that in the control group(37.74%)(P<0.05);The overall satisfaction of treatment work of the observation group was better than that of the control group,and the satisfaction rate of the observation group was significantly higher than that of the control group,with statistically significant differences(P<0.05).Conclus

关 键 词：气道阻塞 经皮环甲膜穿刺置管 气管插管 环甲膜穿刺 面罩吸氧 并发症 

分 类 号：R56[医药卫生—呼吸系统]