双管喉罩在深度昏迷患者院前急救中的应用效果

Application effect of application of double-tube laryngeal mask in pre-hospital first aid for patients with deep coma

目的探讨双管喉罩在深度昏迷患者院前急救中的应用效果。方法选取2019年10月至2020年10月华中科技大学协和深圳医院收治的90例深度昏迷患者作为研究对象,按照数字编号分组方法分为对照组(30例)、对比组(30例)、研究组(30例)。对照组采用气管插管方法,对比组采用口咽通气管方法,研究组采用双管喉罩方法。比较三组的院前急救效果、置管前及置管后30 min的血氧饱和度(SaO_(2))、动脉氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、乳酸(LAC)以及插管时并发症情况。结果研究组的急救效果与对照组比较,差异无统计学意义(P>0.05),研究组的急救效果优于对比组,差异有统计学意义(P<0.05);三组置管后30 min的SaO_(2)、PaO_(2)高于置管前,PaCO_(2)、LAC低于置管前,差异有统计学意义(P<0.05);研究组插管时的并发症总发生率低于对照组及对比组,差异有统计学意义(P<0.05)。结论在深度昏迷患者的院前急救工作中,双管喉罩改善低氧血症与气管插管相接近,但相比之下,双管喉罩的时效性最佳,不仅可以有效改善患者的血气分析指标,还有着较高的安全性,因此双管喉罩在深度昏迷患者院前急救中有理想应用价值。

Objective To explore the effectiveness of application of dual-tube laryngeal mask in pre-hospital first aid for patients with deep coma.Methods A total of 90 patients with deep coma who were treated in Huazhong University of Science and Technology Union Shenzhen Hospital from October 2019 to October 2020 were selected as the objects of this research and divided into the control group(30 cases),the contrast group(30 cases)and the study group(30 cases)according to the number grouping method.The control group was treated with air tube intubation method;the contrast group was treated with oropharyngeal ventilation tube method,and the study group was treated with double-tube laryngeal mask method.The effectiveness of pre-hospital first-aid,blood gas indexes(SaO_(2)),arterial oxygen partial pressure(PaO_(2)),partial pressure of carbon dioxide in artery(PaCO_(2))and lactic acid(LAC)before and 30 min after catheterization and complications during intubation were compared among the three groups.Results There was no significant difference in the first-aid effect between the study group and the control group(P>0.05),but the first-aid effect of the study group was better than that of the contrast group(P<0.05).SaO_(2) and PaO_(2) in the three groups 30 min after catheterization were higher than before catheterization,PaCO_(2) and LAC were lower than those before catheterization,the differences were statistically significant(P<0.05).The total incidence of complications during intubation in the study group was lower than that in the control group and the contrast group,the difference was statistically significant(P<0.05).Conclusion In the pre-hospital first aid of patients with deep coma,the improvement of hypoxemia by double-tube laryngeal mask is close to that by endotracheal intubation.However,in contrast,the double-tube laryngeal mask shows its superiority in the optimal timeliness,which can not only effectively improve the blood gas analysis index of patients,but also has high safety.Therefore,double-tube laryngeal mask has ideal application value in pre-hospital first aid for patients with deep coma.