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目的探讨三种序贯式气道开放法对复苏成功率、复苏后综合征的影响。方法选取2015年1月~2016年1月于广州市黄埔区红十字会医院实施心肺复苏的患者60例,根据随机数字表法将其分为A组(n=20)、B组(n=20)和C组(n=20)。插入气管前,A组患者实施面罩吸氧通气;B组实施口咽通气复苏患者心跳;C组置入喉罩通气复苏患者心跳,三组患者心跳稳定后行气管插管。比较三组复苏成功率,急诊存活率,一次成功置入率,气道有效开放时间,瞳孔由大变小时间,自主循环恢复时间及复苏后1、5 d的APACHEⅡ评分,复苏后0、2、6 h的血液酸碱度(p H),血氧饱和度(SpO_2),氧分压(PO_2)等。结果C组复苏后1、5 d的APACHEⅡ评分均低于A组和B组(P<0.05)。C组复苏成功率为85.00%,急诊存活率为85.00%,明显高于B组的65.00%和60.00%、A组的60.00%和55.00%(P<0.05)。C组气道有效开放时间、瞳孔由大变小时间、自主循环恢复时间均短于A组和B组(P<0.05)。A组和B组复苏后2、6 h的p H均高于复苏后0 h(P<0.05);B组复苏后6 h的SpO_2和PO_2均高于复苏后0、2 h(P<0.05);C组复苏后2、6 h的SpO_2和PO_2均高于复苏后0 h(P<0.05);B组复苏后6 h的SpO_2、PO_2和C组复苏后2、6 h的SpO_2和PO_2均高于A组(P<0.05)。结论喉罩复苏相比较面罩通气和口咽通气更具有优越性,正确使用喉罩复苏可提高复苏成功率,缩短气道开放时间,改善患者血氧指标,是心肺复苏理想的人工通气方式。
Objective To investigate the effects of three sequential open airway methods on the success rate of recovery and post-recovery syndrome. Methods Sixty patients with CPR were recruited from January 2015 to January 2016 in the Red Cross Hospital of Huangpu District, Guangzhou. According to the random number table, 60 patients were divided into group A (n = 20), group B (n = 20) and group C (n = 20). Before insertion into the trachea, the patients in group A received masked oxygen inhalation; the patients in group B underwent oropharyngeal ventilation and resuscitation; the patients in group C received heart rate laryngeal mask ventilation and tracheal intubation. Resuscitation success rate, emergency survival rate, a successful placement rate, effective airway opening time, pupil turnaround time, spontaneous circulation recovery time and APACHEⅡscore 1 and 5 days after resuscitation were compared. After resuscitation 0,2 , Blood pH (p H), blood oxygen saturation (SpO 2), oxygen partial pressure (PO 2) and so on. Results The APACHE Ⅱ scores at 1 and 5 days after resuscitation in C group were lower than those in A and B groups (P <0.05). The successful rate of recovery in group C was 85.00%, the rate of emergency survival was 85.00%, which was significantly higher than 65.00% and 60.00% in group B and 60.00% and 55.00% in group A (P <0.05). The effective time of airway opening in Group C was shorter than that in Group A and Group B (P <0.05). The values of p H at 2 and 6 h after resuscitation in group A and group B were both higher than those at 0 h after resuscitation (P <0.05). SpO 2 and PO 2 at 6 h after resuscitation in group B were both higher than those at 0 h and 2 h after resuscitation ); SpO_2 and PO_2 in group C at 2 and 6 h after resuscitation were both higher than those at 0 h after resuscitation (P <0.05); SpO_2 and PO_2 at 6 h after resuscitation in group B and SpO_2 and PO_2 at 2 and 6 h after resuscitation All higher than A group (P <0.05). Conclusions Laryngeal mask resuscitation is superior to mask ventilation and oropharyngeal ventilation. Proper use of laryngeal mask resuscitation can improve the success rate of resuscitation, shorten the time of airway opening, and improve the oxygen index of patients. It is the ideal artificial ventilation for CPR.