145例现场气管插管在急诊抢救中的应用体会

The Experience of Emergency Trachea Intubation for Patients of Respiratory Function Failure (145 Cases)

目的总结气管插管在急救中应用的经验,以期提高整体急救水平。方法回顾性分析145例急诊气管插管抢救危重病人的临床资料。结果145例急诊气管插管中,138例为一次插管成功,成功率为93.3%,7例为二次插管后成功,插管时间10秒～8分钟,平均时间65秒,中位时间50秒。7例海洛因中毒和15例有机磷杀虫药中毒予以现场气管插管,成功建立人工通气后,经进一步抢救全部存活;84例脑出血的病人行现场气管插管后,82例安全转运至专科治疗,2例死于脑疝;39例现场心肺复苏患者中,气管插管后8例未能恢复有效循环死亡。结论气管插管是急诊抢救危重病人的基础,对保证进一步心肺复苏、挽留手术机会以及提高危重患者抢救成功率有重要意义。

Objective To summarize the experience of emergency trachea intubation to rescue the patients of respiratory function failure in order to improve the ability of general salvage. Methods There were 145 severe cases who had trachea intubation whose clinic data were analysed retrospectively. Results There were 138 cases who got successful trachea intubation in one time, and the successful rate was 93.3%. Seven cases were given a second time trachea intubation. The time of procedure was 10s～8min, and average time was 65s. There were 22 cases of toxicosis (7 because of heroin and 15 because of orgnaophosphorus pesticide) who all recovered completely after timely trachea intubation and successfully advanced ventilation. Eighty-six cases of cranio-bleeding had trachea intubation, among which 82 cases were conveyed to expert treatment, and 2 case died of cerebral hernia. Thirty-nine cases of cardiopulmonary resuscitation had emergency trachea intubation, but 8 died because of uneffective circulation. Conclusions Trachea intubation is the basic treatment of first aid for severe patients before hospitalization, and it is essential for advanced cardiopulmonary resuscitation, opportunity of operation and successful rescue rate.