气囊面罩与气管插管通气联合救治对院前心搏骤停患者预后的影响  

Effect of combined treatment of airbag mask and tracheal intubation ventilation on the prognosis of patients with prehospital cardiac arrest

作　　者：赵军 侣凯 高玫 ZHAO Jun;LV Kai;GAO Mei(Department of Emergency Medicine,Yuncheng First Hospital,Yuncheng 044000,Shanxi,China;Department of Emergency,People’s Hospital of Yanhu District,Yuncheng 044000,Shanxi,China;Department of Emergency,Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China)

机构地区：[1]运城第一医院急诊医学科,山西运城044000 [2]运城市盐湖区人民医院急诊科,山西运城044000 [3]运城市中心医院急诊科,山西运城044000

出　　处：《川北医学院学报》2023年第1期101-104,共4页Journal of North Sichuan Medical College

摘　　要：目的:观察气囊面罩与气管插管通气联合救治对院前心搏骤停(OHCA)患者预后的影响。方法:根据通气方式不同,将采用气管插管通气救治的OHCA患者设为对照组(n=303);采用气囊面罩与气管插管通气联合救治的OHCA患者设为观察组(n=309)。比较两组患者救治成功率及救治前后血气指标、心功能及神经功能恢复情况。心肺复苏(CPR)患者均随访6个月,比较两组生存情况。结果:观察组患者心肺复苏率、脑复苏率、救治成功率、6个月存活率分别为15.21%、7.77%、15.21%、6.80%,均高于对照组的10.56%、3.63%、10.56%、2.64%(P<0.05)。观察组患者呼吸恢复时间、自主循环恢复时间均短于对照组(P<0.05);出院时CPC 1~2级患者占31.92%,高于对照组的12.50%(P<0.05)。两组患者气道开放时间比较,差异无统计学意义(P>0.05)。CPR成功后1、6 h, LVEF、E/A、PaO_(2)、PaO_(2)/FiO_(2)均高于入院即刻,PaCO_(2)均低于入院即刻(P<0.05);观察组LVEF、E/A均高于对照组(P<0.05);而两组PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)比较,差异无统计学意义(P>0.05)。两组CPR成功患者均随访6个月,观察组中位生存时间为146.06 d,对照组为118.58 d,差异有统计学意义(P<0.05)。结论:OHCA患者采用气囊面罩与气管插管通气联合救治可提高CPR成功率,减轻心功能、神经功能损伤,是提高患者预后的有效救治方法。Objective:To observe the effect of combined treatment of airbag mask and endotracheal intubation ventilation on the prognosis of patients with prehospital cardiac arrest(OHCA).Methods:According to different ventilation methods, the OHCA patients treated with tracheal intubation ventilation were set as the control group(n=303),OHCA patients treated with airbag mask and tracheal intubation ventilation were set as the observation group(n=309).The success rate of treatment and the recovery of blood gas indexes, cardiac function and neurological function before and after treatment were compared between the two groups.Cardiopulmonary resuscitation(CPR) patients were followed up for 6 months, and the survival of the two groups was compared.Results:The cardiopulmonary resuscitation rate, cerebral resuscitation rate, rescue success rate and 6-month survival rate of the observation group were 15.21%,7.77%,15.21%,and 6.80%,respectively, which were higher than those of the control group(10.56%,3.63%,10.56%,10.56%,2.64%,P<0.05).The respiratory recovery time and spontaneous circulation recovery time of the observation group were shorter than those of the control group, and the patients with CPC grades 1-2 accounted for 31.92% at the time of discharge, which was higher than 12.50% of the control group(P<0.05).There was no significant difference in airway opening time between the two groups(P>0.05).LVEF,E/A,PaO_(2),PaO_(2)/FiO_(2)at 1 and 6 h after successful CPR were higher than those at the moment of admission, and PaCO_(2)was lower than that at the moment of admission(P<0.05).The LVEF and E/A of the observation group at 1 and 6 h after successful CPR were higher than those of the control group(P<0.05).There was no significant difference in PaO_(2),PaCO_(2),PaO_(2)/FiO_(2)between the two groups at 1 and 6 h after successful CPR(P>0.05).The patients with successful CPR in both groups were followed up for 6 months.The median survival time of the observation group was 146.06 d and that of the control group was 118.58 d, and the d

关 键 词：气囊面罩 气管插管 院前 心搏骤停 预后 

分 类 号：R459.7[医药卫生—急诊医学]