急诊垂危病人的气管插管时机与呼吸管理

Right moment of endotracheal intubation and respiration management in critically ill patients

垂危病人在心跳骤停前多有垂危呼吸的表现,主要有潮式呼吸,间歇呼吸及临终呼吸,为研究垂危病人及心肺复苏病人气管插管的时机及呼吸管理方法,本文对24例出现垂危呼吸的病人即行气管插管,辅以心肺复苏的抢救措施,并对同期38例心跳呼吸停止后插管的病人对照分析,将有关影响抢救成功的因素进行统计学处理。认为垂危呼吸出现时即插管病人,其抢救成功率明显提高。垂危呼吸病人的呼吸管理也较之心跳骤停后的管理有效。因此,急诊垂危病人一旦出现垂危呼吸征象,即应当作心肺复苏开始的指征。

Before cardiac arrest,almost all critically ill patientshave critical respiration,which includes Cheyne-Stokesrespiration,Biot respiration and terminal respiration.Inorder to study the right moment of endotracheal intuba-tion and resuscitation as well as the methods of managingrespiration in the critical condition,we performed endo-tracheal intubation in 24 patients with critical respira-tion,and gave them cardio-pulmonary resuscitation (CPR)and other emergency treatment,we also perforedendotracheal intubation in 38 patients after respiratoryand cardiac arrest(as control group)during the same pe-riod of our study.Factors related to the effects of emer-gency treatments were statistically analyzed.It is believedthat intubation performed immediately after the appear-ante of critical respiration obviously increases the sur-vival rate,and the respiration management in patientswith critical respiration is more efficient than in patientswith cardiac arrest.Thus we suggest that critical respira-tion,once seen in critically ill patients,be considered asan indication of CPR.