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(1)
[摘要] 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(pH)，血氧饱和度(SpO2)，氧分压(PO2)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pH均高于复苏后0 h(P < 0.05)；B组复苏后6 h的SpO2和PO2均高于复苏后0、2 h(P < 0.05)；C组复苏后2、6 h的SpO2和PO2均高于复苏后0 h(P < 0.05)；B组复苏后6 h的SpO2、PO2和C组复苏后2、6 h的SpO2和PO2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。
[关键词] 序贯式气道开放法；复苏成功率；血氧指标；复苏后综合征
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-7210(2016)05(b)-0111-04
[Abstract] Objective To study the effects of three different methods of sequential type airway open on the success rate of recovery and post-resuscitation syndrome. Methods 60 patients treated with cardiopulmonary cerebral resuscitation in the Red Cross Hospital of Huangpu District in Guangzhou City from January 2015 to January 2016 were selected and divided into group A (n=20)， group B (n=20) and group C (n=20) according to random number table method. Before insert the trachea， oxygen mask ventilation was used in group A； oropharyngeal airway was applied in group B； mask gasbag oropharyngeal airway was used in group C， and the trachea were inserted when all patients recovery heart-beating. The success rate of recovery， survival rate， one-time placement rate， airway open time， change time of pupil， restoration time of spontaneous circulation， APACHEⅡ scores after recovery of 1 and 5 d， and pH， blood oxygen saturation (SpO2)， oxygen partial pressure (PO2) after recovery of 0， 2， 6 h among three groups were compared. Results APACHEⅡ scores after recovery of 1 and 5 d in group C were significantly lower than those in group A and group B (P < 0.05). The success rate of recovery and survival rate in group C were 85.00%， significantly higher than those in group B (65.00%， 60.00%) and group A (60.00%， 55.00%)(P < 0.05). The airway open time， change time of pupil and restoration time of spontaneous circulation in group C were shorter than those in group A and group B (P < 0.05). pH after recovery of 2， 6 h in group A and group B were higher than those after recovery of 0 h (P < 0.05). SpO2， PO2 after recovery of 6 h in group B were higher than those after recovery of 0， 2 h (P < 0.05). SpO2， PO2 after recovery of 2， 6 h in group C were higher than those after recovery of 0 h (P < 0.05). SpO2， PO2 after recovery of 6 h in group B and SpO2， PO2 after recovery of 2， 6 h in group C were higher than those in group A (P < 0.05). Conclusion Laryngeal mask recovery has more advantages than oxygen mask ventilation and oropharyngeal airway mask ventilation， proper usage of laryngeal mask can improve the success rate of recovery， shorten the airway open time and improve the patients′ blood oxygen index. It is an ideal way of cardiopulmonary resuscitation. (吴志镛 代成刚 林燕 秦海坚 龙伟杰)
[关键词] 序贯式气道开放法；复苏成功率；血氧指标；复苏后综合征
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-7210(2016)05(b)-0111-04
[Abstract] Objective To study the effects of three different methods of sequential type airway open on the success rate of recovery and post-resuscitation syndrome. Methods 60 patients treated with cardiopulmonary cerebral resuscitation in the Red Cross Hospital of Huangpu District in Guangzhou City from January 2015 to January 2016 were selected and divided into group A (n=20)， group B (n=20) and group C (n=20) according to random number table method. Before insert the trachea， oxygen mask ventilation was used in group A； oropharyngeal airway was applied in group B； mask gasbag oropharyngeal airway was used in group C， and the trachea were inserted when all patients recovery heart-beating. The success rate of recovery， survival rate， one-time placement rate， airway open time， change time of pupil， restoration time of spontaneous circulation， APACHEⅡ scores after recovery of 1 and 5 d， and pH， blood oxygen saturation (SpO2)， oxygen partial pressure (PO2) after recovery of 0， 2， 6 h among three groups were compared. Results APACHEⅡ scores after recovery of 1 and 5 d in group C were significantly lower than those in group A and group B (P < 0.05). The success rate of recovery and survival rate in group C were 85.00%， significantly higher than those in group B (65.00%， 60.00%) and group A (60.00%， 55.00%)(P < 0.05). The airway open time， change time of pupil and restoration time of spontaneous circulation in group C were shorter than those in group A and group B (P < 0.05). pH after recovery of 2， 6 h in group A and group B were higher than those after recovery of 0 h (P < 0.05). SpO2， PO2 after recovery of 6 h in group B were higher than those after recovery of 0， 2 h (P < 0.05). SpO2， PO2 after recovery of 2， 6 h in group C were higher than those after recovery of 0 h (P < 0.05). SpO2， PO2 after recovery of 6 h in group B and SpO2， PO2 after recovery of 2， 6 h in group C were higher than those in group A (P < 0.05). Conclusion Laryngeal mask recovery has more advantages than oxygen mask ventilation and oropharyngeal airway mask ventilation， proper usage of laryngeal mask can improve the success rate of recovery， shorten the airway open time and improve the patients′ blood oxygen index. It is an ideal way of cardiopulmonary resuscitation. (吴志镛 代成刚 林燕 秦海坚 龙伟杰)