小儿心肺复苏即时气管插管对死亡事件的规避作用探讨  

The evasion effectof immediate tracheal intubation during cardiopulmonary resuscitation on death events in children

作　　者：李星 赵丽 LI Xing;ZHAO Li(Emergency Room,Children's Hospital,Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院急诊抢救室,江苏南京210008

出　　处：《实用医院临床杂志》2021年第5期127-130,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨心肺复苏患儿应用即时气管插管方案对死亡事件的规避作用。方法选择我院儿科2019年4月至2020年4月进行心肺复苏救治的患儿80例,采用数字表法分为观察组和对照组各40例,观察组应用入院即时气管插管方案,对照组应用急救后延时气管插管方案,比较两组患儿复苏开始时及复苏后30 min血流动力学参数、炎性因子水平和气管插管成功率、心肺复苏成功率、死亡率。结果两组患儿复苏开始时心率(HR)、动脉血氧饱和度(SpO2)、平均动脉压(MAP)等血流动力学参数指标差异无统计学意义(P<0.05);复苏后30 min时点HR、MAP指标均有所升高,但观察组低于对照组(P<0.05);SpO2升高,且观察组高于对照组(P<0.05)。两组复苏开始时点C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)等炎性因子差异无统计学意义(P>0.05),复苏后30 min时点各指标均有所降低,且观察组低于对照组(P<0.05)。观察组气管插管成功率、心肺复苏成功率均高于对照组,死亡率低于对照组(P<0.05)。结论针对临床收治的呼吸心搏骤停采用心肺复苏救治的患儿,应用即时气管插管方案,可保持血流动力学稳定,降低机体炎性反应程度,并可提升气管插管及心肺复苏成功率,降低死亡事件率。Objective To explore the evasion effect of immediate tracheal intubation on death events in children with cardiopulmonary resuscitation.Methods Eighty children who underwent cardiopulmonary resuscitation in the department of pediatrics of our hospitalfrom April 2019 to April 2020 were selected.The sick children were randomly divided into observation group and control group by using digital table extraction,40 in each group.The observation group was treated with immediate tracheal intubation on admission.The control group wasgiven delayed tracheal intubation program after first aid.Thehemodynamic parameters,theinflammatory factor levels,and thesuccess rate of tracheal intubation and cardiopulmonary resuscitation at the beginning of resuscitation and after 30 minutes of resuscitation were compared between the two groups.The mortality ratewas also compared between the two groups.Results There was no significant difference in hemodynamic parameters such as heart rate(HR),arterial oxygen saturation(SpO2)and mean arterial pressure(MAP)between the two groups at the beginning of resuscitation(P<0.05).Although HR and MAP were increased at 30 min after resuscitation,the observation group was at a lower level when compared with the control group(P<0.05).SpO2 in the observation group was higher than that in the control group(P<0.05).The levels of C-reactive protein(CRP),interleukin 6(IL-6)andinterleukin-8(IL-8)had no difference between the two groups at the beginning of resuscitation(P>0.05),but these inflammatory factors at 30 min after resuscitation were all decreased,and the observation group was lower than the control group(P<0.05).The success rate of tracheal intubation and cardiopulmonary resuscitation in the observation group were higher than those in the control group.The mortality rate in the observation group was lower than that in the control group(P<0.05).Conclusion For clinically admitted children with respiratory and cardiacarrest who are treated with cardiopulmonary resuscitation,the application of immediate t

关 键 词：小儿 呼吸心搏骤停 心肺复苏 血流动力学参数 死亡事件 

分 类 号：R320.61[医药卫生—人体解剖和组织胚胎学]