喉罩通气道与气管内插管在急救复苏中重建有效通气道的对比研究

Laryngeal Mask Airway in Management if Airway of Dying Patients

目的 检测喉罩通气道用于急救复苏中重建有效通气道的优越性。方法 L组 2 0例系各种因素导致呼吸衰竭或呼吸停止的患者 ,选择合适 3～ 4型号的喉罩盲探插入正确位置 ,进行控制呼吸。 E组 2 0例手术麻醉患者 ,在静脉快诱导明视下行气管内插管机械通气 ,观察 2组插管困难程度、插管成功次数、插管时间、插管后 Pet CO2 波形、气道顺应性、SPO2 、胸廓起伏状况、双肺呼吸音。结果 L组盲探下插管全部 1次成功 ,E组诱导明视下插管 1次成功 16例 ,3次以上 4例。插管时间 :L组全部在 30 s内完成 ,E组在 30 s内完成 16例 ,其余长达 1min30 s～ 3min2 0 s(P<0 .0 5 ) ,相比差异有显著性。插管后两组气道顺应性 ,Pet CO2 、SPO2 、双肺呼吸音判断导管位置均正确无误。结论 应用喉罩通气道于急救复苏 ,与使用喉镜明视下快诱导行气管内插管相比 ,具有体位要求不高 ,操作简单 ,可盲探插管 ,为抢救此类患者赢得宝贵的抢救时间。

Objective To evaluate the advantages of Laryngeal Mask Airway (LMA) in airway reconstruction of dying patients.Methods LMA(L) group include 20 patients with respiratory failure or apnea,the proper size tube was inserted blindly into larynx and controlled breath was performed.Endotracheal intubation(E) group included 20 patients on going operation under general anasethesia,after rapid induction intravenously the trachea was intubated under laryngoscope,then mechanical ventilation started.The difficulties,numbers of successes,time of intubation,and PetCO 2 waveform.compliance of airway,SpO 2,breathing sound after intubation were compared between two groups.Results All the intubation succeeded at first attempt and were finished in less than 30 seconds,4 did after 3 times attempts,the time were between 1 minutes 30 seconds and 3 minutes 20 seconds(P<0.05).PetCO 2 waveform,compliance of airway,SpO 2 breathingsound after intubation suggested that the tubes were properly placed in oth groups.Conclusions In airway management of dying patients,Laryngeal Mask Airway(LMA) was more advantageous than endotracheal intubation,which need less time,had less complex performance,demanded ni specific positions and could be done blindly.