快速诱导插管及其护理配合在急诊严重创伤患者中的应用分析  

Application of rapid induction intubation and its nursing cooperation in patients with emergency severe trauma

作　　者：屈万利 柴青青 樊泽 吴莉 QU Wanli;CHAI Qingqing;FAN Ze;WU Li(Department of Emergency Medicine,Xijing Hospital,the First Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710032,China)

机构地区：[1]空军军医大学第一附属医院西京医院急诊科,陕西西安710032

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期379-383,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：陕西省自然科学基础研究计划项目面上项目(2021JM-246)。

摘　　要：目的分析快速诱导插管及其护理配合在急诊严重创伤患者中的应用效果。方法回顾性分析需行气管插管的严重创伤患者的临床资料,根据患者气管插管方式不同分为RSI组(88例,实施快速诱导插管)和常规组(72例,实施传统诱导气管插管),记录两组一次性插管成功率,比较两组在插管前(T_(0))、插管后10 min(T_(1))和插管后1 h(T_(2))时的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))和动脉血二氧化碳分压(PaCO_(2))变化,同时记录两组患者并发症发生率和护理满意度。结果RSI组的一次性插管成功率为100.00%,显著高于常规组的80.56%(χ^(2)=18.752,P<0.001);常规组在T_(2)时间点,其MAP和HR显著高于T_(0)、T_(1)时间点(t=17.849、7.271和5.263、2.052,P<0.001),而与RSI组比较,常规组患者在T_(1)、T_(2)时间点HR和MAP显著升高(t=4.221、8.342和5.719、3.957,P<0.001);与T_(0)时间点比较,RSI组与常规组在T_(1)、T_(2)时间点PaO_(2)与PaCO_(2)均显著升高(t=37.358、52.341和21.879、16.484,P<0.001)与(t=27.047、2.052和29.649、23.847,P<0.001),与T_(1)时间点比较,RSI组与常规组T_(2)时间点PaO_(2)显著升高(t=12.214、8.022,P<0.001),与常规组比较,RSI组患者在T_(1)和T_(2)时间点PaO_(2)显著升高(t=5.916、10.150,P<0.001),而PaCO_(2)均显著降低(t=8.956、8.642,P<0.001);RSI组并发症总发生率为5.68%,显著低于常规组的19.44%(χ^(2)=7.167,P=0.007);RSI组的护理满意度为100.00%,显著高于对照组的94.44%(χ^(2)=6.146,P=0.013)。结论对急诊严重创伤患者进行快速诱导插管能够提高一次性插管成功率,维持患者血流动力学稳定,减少对患者呼吸系统不良影响,降低患者术后并发症,患者护理满意度高。Objective To explore the application of rapid induction intubation and its nursing cooperation in patients with emergency severe trauma.Methods The clinical data of severe trauma patients who needed tracheal intubation were retrospectively analyzed.According to the different methods of tracheal intubation,the patients were divided into RSI group(88 cases,rapid induction intubation)and conventional group(72 cases,traditional induction intubation).The success rate of one-time intubation was recorded,and the heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2)),arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of blood carbon dioxide(PaCO_(2))were compared between groups before intubation(T_(0)),at 10 min(T_(1))or 1h(T_(2))after intubation,and the incidence rates of complications and nursing satisfaction were recorded in the two groups.Results The success rate of one-time intubation in RSI group with 100.00%was significantly higher than 80.56%in conventional group(χ^(2)=18.752,P<0.001).The HR and MAP at T_(2)in conventional group were significantly higher than those at T_(0)and T_(1)(t=17.849,7.271,5.263,2.052,P<0.001),but the HR and MAP were significantly increased in conventional group at T_(1)and T_(2)compared with those in RSI group(t=4.221,8.342,5.719,3.957,P<0.001).Compared with at T_(0),the PaO_(2)and PaCO_(2)were significantly increased in RSI group and conventional group at T_(1)(t=37.358,52.341,21.879,16.484,P<0.001)and T_(2)(t=27.047,2.052,29.649,23.847,P<0.001),and PaO_(2)at T_(2)was significantly increased in RSI group and conventional group compared with that at T_(1)(t=12.214,8.022,P<0.001).Compared with conventional group,the PaO_(2)was significantly increased(t=5.916,10.150,P<0.001)while the PaCO_(2)was significantly decreased(t=8.956,8.642,P<0.001)in RSI group at T_(1)and T_(2).The total incidence rate of complications was 5.68%in RSI group,which was significantly lower than 19.44%in conventional group(χ^(2)=7.167,P=0.007).The nursing satisfaction in RSI gr

关 键 词：快速诱导插管 急诊 严重创伤 一次性插管成功率 血流动力学 并发症 护理满意度 

分 类 号：R473.6[医药卫生—护理学]