喉罩与气管插管在呼吸衰竭患者院前和急诊急救中的应用效果比较

目的:探讨喉罩与气管插管在呼吸衰竭患者院前和急诊急救中的应用效果。方法:选择2016年1月至2018年5月由中国人民解放军第174医院急诊医学科出诊抢救的呼吸衰竭患者92例,所有患者根据通气方法的不同分为A组和B组。其中A组使用喉罩人工通气方法进行急救,共有47例,而B组则使用气管插管人工通气方法进行急救,共有45例,比较两组患者治疗前与治疗1 h后呼吸频率(RR)、心率(HR)以及血氧饱和度(SpO_2)等生命体征指标,对比喉罩与气管插管置入时间、一次性成功率、心肺复苏成功率情况,记录两组并发症发生情况。结果:两组患者治疗前HR、RR以及SpO_2比较差异无统计学意义(P0.05),两组患者治疗1 h后HR、RR均较治疗前降低,SpO_2较治疗前升高(P0.05),两组患者治疗1h后HR、RR以及SpO_2比较差异无统计学意义(P0.05)。A组的喉罩插管置入时间明显短于B组的气管插管置入时间,且A组插管一次性成功率明显高于B组,两组比较差异具有统计学意义(P0.05),而两组心肺复苏成功率比较差异无统计学意义(P0.05)。A组并发症发生率为2.13%(1/47),低于B组的并发症发生率13.33%(6/45),差异具有统计学意义(P0.05)。结论:喉罩通气与气管插管通气效果基本一致,但其操作更简单更安全,可缩短插管置入时间,提高一次性成功率,争取抢救时间。

Comparison the Applicative Effect of Laryngeal Mask and Endotracheal Intubation for Patients with Respiratory Failure in Pre-hospital Care and Emergency Treatment

ABSTRACT Objective: To explore the applicative effect of laryngeal mask and endotracheal intubation for patients with respiratory failure in the pre-hospital care and emergency treatment. Methods: 92 cases of patients with respiratory failure who were rescued by emergency medicine department in The 174th Hospital of PLA from January 2016 to May 2018 were selected.All patients were divided into group A and group B according to different ventilation methods. Group A were used laryngeal mask artificialventilation to carry out pre-hospital care, it had a total of 47 cases. Group B were used endotracheal intubation and artificial ventilation to carry out pre-hospital care, it had a total of 45 cases. The vital signs of respiratory rate(RR), heart rate(HR) and blood oxygen saturation (SpO₂) were compared between the two groups before treatment and 1h after treatment. The time of laryngeal mask and endotracheal intubation, one-time success rate and success rate of cardiopulmonary resuscitation were compared, and the complications of the two groups were recorded. Results: There was no significant difference in HR, RR and SpO₂ between the two groups before treatment(P>0.05). 1 h after treatment, the HR and RR in the two groups were lower than before treatment, the SpO₂ was higher than before treatment(P<0.05). 1 h after treatment, there was no significant difference in HR, RR and SpO₂ between the two groups(P>0.05). The laryngeal mask insertion time in group A was significantly shorter than group B, and the one-time success rate in group A was obviously higher than group B, the differences between the two groups were statistically significant(P<0.05). There was no significant difference in the success rate of cardiopulmonary resusci- tation between the two groups(P>0.05). The incidence of complications in group A were 2.13% (1/47), were lower than 13.33%(6/45) in group B, and the differences were statistically significant(P<0.05). Conclusion: The effect of laryngeal mask ventilation and endotracheal intubation ventilation is basically the same, but the operation is simpler and safer, it can shorten the insertion time of intubation, increase the one-time success rate, and strive for rescue time.