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目的:比较急救车内3种方法建立人工气道所需时间及复苏成功率。方法:对急救车上发生心跳呼吸骤停的患者318例,根据心肺复苏(CPR)时对患者建立人工气道的不同方法将其分为3组。A组68例,常规行气管导管插管;B组140例,盲插喉罩通气;C组110例,食道气管联合导管通气。比较3组建立人工通气所需时间、一次插管成功率、复苏成功率的不同,采用SPSS 13.0 For windows软件分析,判断各组差异显著性。结果:A组建立人工通气所需时间为(146±14.7)s;B组为(26±11.3)s;C组为(81±16.5)s;B组、C组分别与A组比较,差异非常显著。A组一次插管成功41例,成功率60.3%;B组全部一次成功,成功率100%;C组108例一次成功,成功率98.2%。B、C组与A组比较差异非常显著(P<0.01),B组与C组比较差异不显著(P>0.05)。A组复苏成功18例,成功率26.5%;B组复苏成功36例,成功率25.7%;C组复苏成功30例,成功率27.3%。A、B、C 3组复苏成功率比较差异不显著(P>0.05)。结论:院前急救车上CPR建立人工气道时,使用盲插喉罩和食道气管联合导管通气,具有操作方便、快捷实用的优越性,应该进一步推广应用。
OBJECTIVE: To compare the time required for establishment of artificial airway and the success rate of resuscitation with 3 methods in ambulance. Methods: Thirty-eight patients with sudden cardiac arrest on emergency ambulance were divided into three groups according to different methods of establishing artificial airway during cardiopulmonary resuscitation (CPR). A group of 68 patients, routine endotracheal intubation; B group 140 cases, blind mastectomy ventilation; C group of 110 cases, esophageal tracheal catheter ventilation. The time required to establish artificial ventilation, the success rate of primary intubation and the success rate of recovery were compared among the three groups. SPSS 13.0 For windows software was used to analyze the significant difference between the groups. Results: The duration of artificial ventilation was (146 ± 14.7) s in group A, (26 ± 11.3) s in group B and (81 ± 16.5) s in group C. The difference between group B and group C was statistically significant Very significant. A group of successful intubation in 41 cases, the success rate of 60.3%; B group all successful, the success rate was 100%; C group of 108 cases a success, the success rate of 98.2%. There was significant difference between group B and group C (P <0.01). There was no significant difference between group B and group C (P> 0.05). A group of 18 cases of successful recovery, the success rate of 26.5%; B group of 36 cases of successful resuscitation, the success rate of 25.7%; C group of 30 cases of successful recovery, the success rate of 27.3%. There was no significant difference in the success rate of recovery between groups A, B and C (P> 0.05). CONCLUSION: When CPR is used to establish artificial airway in pre-hospital ambulance, the blind airway laryngeal mask and esophageal tracheal catheter are used to ventilate airway. It has the advantages of convenient operation, quick and practical application and should be further popularized and applied.