早期气管插管对心肺复苏抢救窒息病人的临床意义

Abstract

目的：探讨早气管插管对提高急诊窒息病人心肺复苏(CPR)成功率的影响。方法：回顾性分析2008年2月到2015年2月两所医院急诊救治的86例因窒息导致心脏骤停患者。其中心脏骤停后胸外按压5分钟内给予气管插管术48例，超过5分钟以上时间给予气管插管术38例。所有病例均施与人工胸外心脏按压，肾上腺素静注，以及在适应症范围内电击复律等抢救措施。结果：因窒息导致的心脏骤停5分钟内给予气管插管术的48例中，32例复苏成功，成功率67%，有效43例(90%)；超过5分钟以上时间给予气管插管术的38例中,抢救成功3例(8%)，有效20例(53%)。结论：因窒息导致心脏骤停的病人早期进行气管插管术配合常规心肺复苏处理提高了心肺复苏的成功率。 Objective: To investigate the success rate of cardiopulmonary resuscitation by early endotracheal intubation for patients with asphyxia in emergency treatment. Methods: Retrospective analysis of clinical data from 86 cardiac arrest patients caused by asphyxia rescued in emergency room in two hospitals during the course from February 2008 to February 2015. Among these patients, 48 patients were treated with endotracheal intubation within 5 minutes of chest compression after heart arrest and 38 patients were given the same treatment after 5 minutes of chest compression. All patients were offered chest compressions, intravenous epinephrine, cardioversion and other life support treatments within indications. Results: 32 of 48 patients were successfully rescued with endotracheal intubation within 5 minutes (67% of successful rate) and 43 of 48 patients were responded by the same treatment (90% of response rate). In contrast, 3 of 38 patients were suc-cessfully rescued with endotracheal intubation after 5 minutes (8% of successful rate) and 20 of 38 patients were responded by the same treatment (53% of response rate). Conclusion: Early phase endotracheal intubation combined with regular cardiopulmonary resuscitation increased the success rate of cardiopulmonary resuscitation for cardiac arrest patients caused by asphyxia.