气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响

Effect of air bag mask and tracheal intubation ventilation on resuscitation outcome and prognosis in first aid cardiopulmonary resuscitation

摘要:

目的 探讨气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响。方法 选取2015年1月—2017年5月在重庆医科大学附属大学城医院接受急救心肺复苏患者102例，采用随机数字表法将分为观察组和对照组，每组51例。对照组给予气管插管通气治疗，观察组给予气囊面罩结合气管插管通气治疗。比较两组患者治疗前后的pH、氧分压（PO₂）、二氧化碳分压（PCO₂）水平变化；记录两组患者治疗后气道开放、呼吸恢复、心跳恢复及意识改善时间；比较两组患者治疗后生命体征指标恢复情况、复苏成功率、最终存活率及满意度情况。结果 治疗前，两组患者的pH、PO₂、PCO₂比较无统计学意义（P >0.05）。治疗后，两组患者的pH、PO₂均有所升高，但是观察组pH（7.29±0.12）mmHg低于对照组（7.53±0.22）mmHg（P <0.05），观察组PO₂（89.34±7.69）mmHg高于对照组（71.56±6.98）mmHg （P <0.05）；两组患者的PCO₂均有所降低，但是观察组的PCO₂（37.43±5.25）mmHg低于对照组（44.32±6.51）mmHg （P <0.05）。观察组气道开放、呼吸恢复、心跳恢复及意识改善时间都短于对照组（P <0.05）。观察组血氧饱和度（85.32±11.76）%高于对照组（43.54±9.12）% （P <0.05），平均动脉（72.32±9.56）mmHg高于对照组（36.78±7.32）mmHg （P <0.05）。观察组复苏成功率（52.94% VS 25.49%）、最终存活率均高于对照组（33.33% VS 11.76%） （P <0.05）。观察组总满意率高于对照组（86.27% VS 62.75%） （P <0.05）。结论 采用气囊面罩与气管插管通气结合进行急救心肺复苏，能有效改善患者的pH、PO₂、PCO₂，促进患者的各项生命体征的恢复，缩短患者气道开放、呼吸恢复、心跳恢复及意识改善时间，提高复苏成功率及最终存活率，从而提高患者的满意度。治疗效果显著，值得推广使用。

Abstract:

Objective To investigate the effect of balloon mask and endotracheal intubation on resuscitation outcome and prognosis in emergency resuscitation.Methods A total of 102 patients receiving emergency CPR from January 2015 to May 2017 in University Town Hospital Affiliated to Chongqing Medical University were selected. The patients were divided into two groups (n = 51 in each group) with random number table. The control group was given first aid by routine tracheal intubation ventilation. The observation group was given tracheal intubation on the basis of the control group for first aid. The changes of pH, PO₂ (partial pressure of oxygen) and PCO₂ (partial pressure of carbon dioxide) before and after treatment were compared between two groups. The airway opening, respiratory recovery, heart rate recovery, and consciousness improvement time were recorded after treatment. The recovery of vital signs and the success rate of resuscitation, final survival and satisfaction were compared between the two groups after treatment.Results Before treatment, there was no significant difference in pH, PO₂, and PCO₂ between the two groups (P > 0.05). After treatment, the pH value, and PO₂ of both groups increased. However, the observation group pH (7.29 ± 0.12) was lower than that of the control group (7.53 ± 0.22) (P < 0.05). The PO₂ of the observation group (89.34 ± 7.69) mmHg was significantly higher than that of the control group (71.56 ± 6.98) mmHg , but the PCO₂ (37.43 ± 5.25) mmHg in the observation group was lower than that in the control group (44.32 ± 6.51) mmHg (P < 0.05). In the observation group, the time of airway opening, respiration, heartbeat recovery, and consciousness improvement were both shorter than those in the control group (P < 0.05). The oxygen saturation of the observation group was higher than that of the control group (85.32 ± 11.76% VS. 43.54 ± 9.12%, 72.32 ± 9.56 mmHg VS. 36.78 ± 7.32 mmHg, P < 0.05). The successful rate of resuscitation and the final survival of the observation group were higher than those of the control group (52.94% VS. 25.49%, 33.33% VS. 11.76%, P < 0.05). The total satisfaction rate of the observation group was higher than that of the control group (86.27% VS. 62.75%, P < 0.05).Conclusion First-aid cardiopulmonary resuscitation with balloon mask and endotracheal intubation can effectively improve the patient's pH, PO₂, and PCO₂, promote the recovery of vital signs and shorten the airway opening, respiration, and heart rate recovery time, improve the success rate of resuscitation and the final survival rate, thereby enhancing patient satisfaction, which is worth of promotion.