喉罩人工呼吸支持对急诊科心肺复苏患者血流动力学及复苏后综合征的影响

Effect of laryngeal mask airway support on hemodynamics and post-resuscitation syndrome in patients with cardiopulmonary resuscitation in emergency department

目的探究喉罩人工呼吸支持对急诊科心肺复苏患者血流动力学及复苏后综合征的影响。方法选取自2014年1月至2016年1月我院急诊科收治的心肺复苏患者100例,回顾性分析患者病例资料,按照患者接受不同呼吸支持,分为对照组和观察组各50例。对照组患者实施面罩吸氧+气管插管,观察组患者实施喉罩人工呼吸支持。比较两组患者复苏后的临床效果、血流动力学变化及复苏后综合征的发生率。结果观察组SpO_2上升时间、插管所需时间、气道有效开放时间、瞳孔由大变小时间、自主循环恢复时间均短于对照组,复苏成功率、一次性插管成功率均高于对照组,比较具有统计学意义(P<0.05);与复苏前比较,观察组复苏成功后2h、6h的SpO_2、PaO_2值均明显升高,且较对照组相应时间点的SpO_2、PaO_2值高,组内不同时间点及组间比较差异均具有统计学意义(P<0.05);观察组复苏成功后2h、6h的MAP、CVP值均较复苏前升高,且高于对照组相应时间段的MAP、CVP值,组内不同时间点及组间比较差异均具有统计学意义(P<0.05);观察组的复苏综合征发生率、死亡率及并发症总发生率均较对照组低,比较差异具有统计学意义(P<0.05)。结论喉罩人工呼吸支持能有效改善心肺复苏患者的血流动力学指标,提高复苏成功率,降低复苏后综合征的发生率,可作为理想的心肺复苏人工通气方式。

Objective To investigate the effect of laryngeal mask airway support on hemodynamics and post-resuscitation syndrome in patients undergoing cardiopulmonary resuscitation. Methods The clinical information of 100 cardiopulmonary resuscitation patients from January 2014 to January 2016 were retrospectively analyzed. According to the different breathing support they received, they were divided into the control group and the observation group, 50 cases in each group. The control group was treated with mask oxygen ＋ tracheal intubation, and the observation group was treated with artificial respiration of laryngeal mask. The clinical outcomes, hemodynamic changes and the incidence of post-resuscitation syndrome were compared between the two groups after resuscitation. Results The rise time of SpO2, the time required for intubation, the effective open time of airway, the time of pupil change from small to large, and the recovery time of spontaneous circulation were all shorter in the observation group than in the control group, and the success rate of resuscitation and intubation only once were higher in the observation group than in the control group （P 〈 0. 05） . Compared with before resuscitation, the levels of SpO2 and PO2 in the observation group were significantly higher than those in the control group at 2 and 6 hours after successful resuscitation, and they were higher than those in the control group at the same time point （P 〈0. 05 ） . The value of MAP and CVP of the observation group at 2 h and 6 h after resuscitation were higher than those before resuscitation, and were significantly higher than those in the control group at the same time （P 〈0. 05） . The incidence of resuscitation syndrome, mortality and complications in the observation group were lower than those in the control group （ P 〈 0. 05 ）. Conclusion Laryngeal mask airway support can effectively improve the hemodynamic indexes of cardiopulmonary resuscitation patients, improve the success rate of resuscitation and reduce the incidence of post-resuscitation syndrome, which could be used as an ideal artificial ventilation method for cardiopulmonary resuscitation.