影响基层医院急诊科危重患者紧急气管插管成功率的相关因素分析  

Analysis of Related Factors Affecting the Success Rate of Emergency Endotracheal Intubation in Critical Patients in Emergency Department of Grass-roots Hospital

作　　者：张倔铭 李小燕 章绵程 ZHANG Jueming;LI Xiaoyan;ZHANG Miancheng(Emergency Department,Xinzao Hospital,Panyu District,Guangzhou,Guangdong 511400;Internal Medicine,Lingshan Hospital,Nansha District,Guangzhou,Guangdong 511473;Internal Medicine,Lanhe Hospital,Nansha District,Guangzhou,Guangdong 511473)

机构地区：[1]广州市番禺区新造医院急诊科,广东广州511400 [2]广州市南沙区灵山医院内科,广东广州511473 [3]广州市南沙区榄核医院内科,广东广州511473

出　　处：《智慧健康》2022年第11期77-79,共3页Smart Healthcare

摘　　要：目的 分析和研究影响基层医院急诊科危重患者紧急气管插管成功率的相关因素分析。方法 选取本院2019年7月-2021年7月急诊科救治均实施了气管插管的急危重患者68例,回顾所选患者临床资料,进行分析研究影响气管插管成功率的相关因素。结果 本组68例急诊科危重患者气管插管中,气管插管成功52例(插管成功组),气管插管失败16例(插管失败组),插管成功率76.47%。单因素分析结果显示,插管失败组中患者BMI≥30kg/m;、插管指征不完全符合、患者合并昏迷、操作者不熟练、未使用麻醉药物、未定时对呼吸道吸引分泌物的比例均高于插管成功组(P <0.05),差异有统计学意义。多因素Logistic回归分析结果显示:BMI、插管指征、患者合并昏迷、操作者熟练程度、使用麻醉药物、定时对呼吸道吸引分泌物是影响急诊科危重患者紧急气管插管成功率的独立危险因素。结论 急诊科急危重患者气管插管成功率受肥胖指数,意识状态,插管指征,操作者熟练程度,是否定期吸引气道异物等因素影响较大。Objective To analyze and study the factors affecting the success rate of emergency endotracheal intubation in the emergency department of grass-roots hospitals. Methods 68 emergency and critical patients who had been treated with endotracheal intubation in the emergency department of our hospital from July 2019 to July 2021 were selected, the clinical data of the selected patients were reviewed, and the related factors affecting the success rate of endotracheal intubation were analyzed. Results 68 emergency departments in this group In critically ill patients with endotracheal intubation, endotracheal intubation was successful in 52 cases(intubation success group) and failed in 16 cases(intubation failure group) The success rate of intubation was 76.47%. The results of univariate analysis showed that the proportion of patients with BMI≥30kg/m~2, incompletely consistent intubation indications, coma, unskilled operators, no use of narcotic drugs and irregular attraction of secretions to the respiratory tract in the intubation failure group was higher than that in the intubation success group(P <0.05), the difference was statistically significant. The results of multivariate logistic regression analysis showed that BMI, intubation indications, coma, operator proficiency, use of narcotic drugs and regular suction of respiratory secretions were independent risk factors affecting the success rate of emergency endotracheal intubation in critical patients in emergency department. Conclusion The success rate of endotracheal intubation in critical patients in emergency department was affected by obesity index, Consciousness, intubation indication, operator proficiency, whether to regularly attract airway foreign bodies and other factors have a great impact.

关 键 词：急诊科 急危重患者 气管插管 成功率 

分 类 号：R459.7[医药卫生—急诊医学]