可视喉镜用于脑出血昏迷患者气管插管的院前急救效果及安全性分析  

Analysis on the Pre-Hospital Emergency Care Effect and Safety of Visual Laryngoscope Applied in Tracheal Intubation for Comatose Patients with Cerebral Hemorrhage

作　　者：王华 WANG Hua(Yangzhou Emergency Center,Yangzhou 225007,China)

机构地区：[1]江苏省扬州市急救中心,江苏扬州225007

出　　处：《临床医学工程》2025年第3期299-302,共4页Clinical Medicine & Engineering

摘　　要：目的 探讨可视喉镜用于脑出血昏迷患者气管插管的院前急救效果及安全性。方法 回顾性分析2021年7月至2024年6月接受院前急救的94例脑出血昏迷患者的临床资料,根据气管插管方式分为两组各47例。对照组采用常规喉镜下气管插管,观察组采用可视喉镜下气管插管。比较两组的插管情况、血流动力学指标、应激指标及并发症。结果 观察组的插管及暴露声门时间均短于对照组,1次插管成功率高于对照组(P <0.05)。观察组的声门暴露效果优于对照组(P <0.05)。观察组的并发症发生率为6.38%,低于对照组的23.40%(P <0.05)。插管后即刻及插管后3 min,两组的HR、 MAP均高于插管前,但观察组的HR、 MAP均低于对照组(P <0.05)。插管后即刻及插管后3 min,两组的AngⅡ、 Cor、 NE水平均高于插管前,但观察组的AngⅡ、 Cor、 NE水平均低于对照组(P <0.05)。结论 可视喉镜用于脑出血昏迷患者气管插管中可提高插管准确度及插管效率,减轻对机体血流动力学及应激指标的刺激,降低并发症发生率,值得在院前急救中推广。Objective To explore the pre-hospital emergency care effect and safety of visual laryngoscope applied in tracheal intubation for comatose patients with cerebral hemorrhage.Methods The clinical data of 94 comatose patients with cerebral hemorrhage who received pre-hospital emergency care from July 2021 to June 2024 were retrospectively analyzed.Patients were divided into two groups according to the methods of tracheal intubation,with 47 cases in each group.The control group underwent conventional laryngoscope-guided tracheal intubation,while the observation group underwent visual laryngoscope-guided tracheal intubation.The intubation conditions,hemodynamic parameters,stress indicators,and complications were compared between the two groups.Results The intubation time and glottal exposure time of the observation group were shorter than those of the control group,and the success rate of intubation was higher than that of the control group(P<0.05).The glottal exposure effect of the observation group was better than that of the control group(P<0.05).The incidence of complications in the observation group was 6.38%,lower than the 23.40%in the control group(P<0.05).Immediately after intubation and 3 minutes after intubation,the HR and MAP of both groups were higher than those before intubation,while the HR and MAP of the observation group were lower than those of the control group(P<0.05).Immediately after intubation and 3 minutes after intubation,the levels of AngⅡ,Cor,and NE in both groups were higher than those before intubation,while the levels of AngⅡ,Cor,and NE in the observation group were lower than those in the control group(P<0.05).Conclusions The use of visual laryngoscope in tracheal intubation for comatose patients with cerebral hemorrhage can improve intubation accuracy and efficiency,reduce stimulation on hemodynamics and stress indicators,and lower the incidence of complications,which is worthy of promotion in pre-hospital emergency care.

关 键 词：可视喉镜 脑出血 昏迷 气管插管 院前急救 

分 类 号：R459.7[医药卫生—急诊医学]