呼吸机面罩通气用于气管插管前的效果观察

Effect observation of ventilator face-mask mechanical ventilation applied before tracheal intubation

目的比较呼吸机面罩通气和简易呼吸器面罩通气在ICU紧急床旁气管插管前的应用效果。方法采取临床随机对照研究,对符合纳入标准的100例需紧急气管插管的患者,按入住ICU顺序编号,并根据随机数字表法,分为两组,每组50例。在气道开放后,辅助通气间,观察组使用呼吸机面罩通气,对照组使用简易呼吸器面罩通气,监测两组患者SPO2开始上升所需时间、上升达目标值(SPO2≥95%)所需时间;比较两组患者在气管插管过程中心率、血压的变化情况;分析两组患者插管前、后血气分析的变化情况。结果观察组SPO2开始上升时间及达目标值所需时间均低于对照组,差异有统计学意义(P<0.05)。在插管过程中,观察组心率、血压升高的例数低于对照组,差异有统计学意义(P<0.05)。血气分析结果显示:观察组插管后,PaO2高于对照组,PaCO2低于对照组,差异有统计学意义(P<0.05)。观察组插管后,PaO2、高于插管前,PaCO2低于插管前,差异有统计学意义(P<0.05)。结论呼吸机面罩通气,供氧浓度100%;潮气量确切可靠,气道峰压控制准确,PEEP适宜,能快速改善机体缺氧状态,增加机体组织氧气储备,更能耐受无通气期的气管插管;优化了抢救流程,减少并发症的发生,和呼吸器面罩通气相比较,具有明显的优势。

Objective To compare the application effect of ventilator face-mask mechanical ventilation and simple respirator mask ventilation before tracheal intubation in the ICU emergency. Methods By randomized controlled clini- cal study,100 patients who need emergency tracheal intubation were stochastically and randomly divided into two groups, the observation group used ventilator face-mask mechanical ventilation and the control group used simple res pirator mask ventilation. The required time of SPO2 starting to increase and raised to 95 % in each group was moni- tored. The changes of heart rate and blood pressure was compared. The changes of blood gas analysis before and af- ter tracheal intubation was measured. Results The required time of SPO2 starting to increase and raised to 95% for observation group was significant shorter than that of the control group（P〈0.05）. The rates for patients whose heart rate and blood pressure after intubation in observation group was significant lower than that of the control group（P〈0. 05）. PaO2 for patients in observation group was significant higher than that of the control group,and PaCO2 for patients in observation group was significant lower than that of the control group（P〈0.05）. PaO2 for patients after tracheal intubation was significant higher than before intubation,and PaCO2 for patients after tracheal intubation was significant lower than that before intubation （P〈0.05）. Conclusion With the ventilator face-mask me- chanical ventilation supplied 100% Oxygen,the tidal volume and peak airway pressure can be exactly controlled and PEEP is suitable. It can improve the hypoxia situation rapidly and increase 02 storage quantity, and make the pa- tients more tolerant during tracheal intubation, ventilator face mask mechanical ventilation has obvious advantages which can optimize the emergency treatment process and reduce the complication.