急危重症患者急诊呼吸阶梯性治疗的临床疗效评估

Evaluation of the Clinical Efficacy of Stepwise Respiratory Support in Emergency for Severe Patients

目的分析急危重症患者使用急诊呼吸阶梯性治疗的疗效和优势。方法选择宝鸡市第二人民医院2010年1月至2012年12月收治的184例急危重症患者作为研究对象,按照随机数字表法将患者分为治疗组(92例)和对照组(92例)。对照组患者采取传统呼吸支持抢救方法进行治疗,治疗组患者采取呼吸阶梯性治疗方法进行治疗,比较两组患者呼吸支持方式、呼吸复苏稳定率及呼吸稳定时间的差别。结果两组患者所采取的呼吸支持方式位于前3位的均为鼻导管吸氧、复苏体位及呼吸机给氧,治疗组采用复苏体位进行呼吸支持的患者显著多于对照组(χ2=4.079,P<0.05),而采用气管切开的患者显著少于对照组(χ2=48.915,P<0.05),其余呼吸支持方式比较无统计学意义(P>0.05)。治疗组患者的呼吸复苏率显著高于对照组,呼吸稳定时间显著短于对照组(χ2=4.059,t=15.012,P<0.05)。结论急诊呼吸阶梯性治疗可有效地提高危重患者呼吸支持管理的效果,呼吸复苏稳定率及呼吸复苏时间均有显著改善,值得在临床推广。

Objective To analyze the therapeutic effect and advantages of stepwise respiratory support in emergency for severe patients. Methods From January 2010 to December 2012,184 patients with emer- gency admitted to Baoji Second People＇s Hospital were chosen as the research objects, and then randomly divided into treatment group and control group,92 cases in each group. The treatment group was treated with stepwise respiratory support, the control group was treated with traditional respiratory support. The way of respiratory support,resuscitation rate and steady breathing time of the two groups were compared. Results The top three respiratory support methods of the two groups were nasal cannula oxygen, recovery position and ventilator support. The patients of the treatment group adopting recovery positition were significantly more than the control group （ X2 =4. 079,P 〈0.05 ） ,while the patients who used traeheotomy were significantly less than the control group （ X2 = 48.915, P 〈 0.05 ）, there were no significant difference in other respiratory support methods（P〉 0.05 ）. Respiratory recovery rate of the treatment group was significantly higher than that of the control group, and respiratory stabilization time was significantly shorter than that of the control group （ X2 = 4. 059,t = 15.012, P 〈 0.05 ）. Conclusion Stepwise respiratory support in emergency could markedly enhance the efficiency of respiratory support, improve respiratory recovery rate and respiratory stabilization time,which is worthy of spreading.