快速维护循环与重建呼吸在重症胸外伤患者救治中的效果

Study on the effect of rapid maintenance cycle and rebreathing in patients with severe chest trauma

目的探讨快速维护循环与重建呼吸在重症胸外伤患者救治中的效果。方法回顾性选取2014年8月至2018年8月苏州大学附属太仓医院收治的重症胸外伤患者60例,依据救治方法分为两组:一组为常规救治组(n=30),一组为常规救治联合快速维护循环与重建呼吸救治组(联合救治组,n=30),统计分析两组患者的心率(HR)、呼吸频率(RR)、动脉血氧分压(PaO2)和临床疗效。结果联合救治组患者救治前的HR、RR、PaO2分别为(108. 4±13. 7)次/min、(28. 1±5. 9)次/min、(50. 0±6. 9) mm Hg,救治后分别为(83. 3±7. 6)次/min、(17. 6±4. 2)次/min、(88. 5±7. 8)mm Hg;常规救治组患者救治前的HR、RR、PaO2分别为(108. 5±13. 7)次/min、(28. 5±6. 5)次/min、(49. 3±7. 2) mm Hg,救治后的HR、RR、PaO2分别为(98. 2±8. 5)次/min、(27. 8±5. 6)次/min、(75. 4±8. 0) mm Hg。救治前,两组患者HR、RR、PaO2相比,无显著差异(t=1. 886,1. 638,1. 533,P> 0. 05);救治后,两组患者HR、RR均显著降低(P <0. 05),PaO2均显著升高(P <0. 05);救治后,与常规救治组相比,联合救治组患者的HR、RR均显著降低(t=4. 303,3. 182,P<0. 05),PaO2显著升高(t=6. 965,P <0. 05)。联合救治组患者治疗的总有效率96. 7%(29/30)显著高于常规救治组63. 3%(19/30),差异有显著性(χ2=13. 34,P <0. 05)。结论与常规救治相比,快速维护循环与重建呼吸在重症胸外伤患者救治中的能显著降低患者的心率和呼吸频率,提高动脉血氧分压,提高临床疗效,值得在临床推广。

Objective To explore the effect of rapid maintenance of circulation and reconstruction of breathing function in treatment of patients with severe thoracic trauma. Methods The clinical data of 60 patients with severe thoracic trauma during August 2016 to August 2018 were retrospectively selected for this study. These patients were divided into two groups by random table method. Patients in group 1 were treated with conventional treatment (n=30), patients in another group were treated by conventional treatment combined with rapid maintenance of circulation and reconstruction of respiratory system (combination treatment group, n=30). The heart rate (HR), respiratory frequency (RR), arterial partial pressure of oxygen (PaO 2) and clinical efficacy of patients in these two groups were statistically analyzed. Results The HR, RR and PaO 2 before treatment were (108.4±13.7) times/min,(28.1±5.9) times/min,(50.0±6.9) mmHg respectively in combination treatment group, HR, RR and PaO 2 before treatment were (83.3±7.6) times/min,(17.6±4.2) times/min,(88.5±7.8)mmHg. HR, RR and PaO 2 before treatment were (108.5±13.7 times/min,(28.5±6.5) times/min,(49.3±7.2) mmHg in conventional treatment group, HR, RR and PaO 2 after treatment were (98.2±8.5) times/min,(27.8±5.6) times/min and (75.4±8.0) mmHg, respectively. Before treatment, there was no significant difference in HR, RR and PaO 2 between these two groups ( t =1.886, 1.638, 1.533, P >0.05). After treatment, HR and RR in both groups were significantly decreased ( P <0.05), and PaO 2 was significantly increased P <0.05). After treatment, HR and RR in combination group were significantly decreased ( t =4.303, 3.182, P <0.05), while PaO 2 was significantly increased ( t =6.965, P <0.05). The total effective rate of combination treatment group was 96.7%(29/30) it was significantly higher than that [63.5%(19/30)] of conventional treatment group, and the difference was significant (χ 2=13.34, P <0.05). Conclusion In comparison with routine treatment, rapid maintenance of circulation and reconstruction of respiratory system in treatment of patients with severe thoracic trauma can significantly reduce the heart rate and respiratory rate, increase arterial oxygen partial pressure, and improve the clinical efficacy. Hence it is worthy to be promoted for clinical application.