CAJ | 학술논문

　　目的研究喉罩应用于院前急救时建立紧急气道的临床效果。方法2010年6月至2012年12月100例院前心跳呼吸骤停或严重呼吸衰竭的患者，随机分为喉罩组（LMA组，n=50）和气管导管组（TT组，n=50）。两组分别置入喉罩或插入气管导管，其它抢救措施均按常规进行。观察记录两组患者喉罩置入/气管内插管的次数、所耗费的时间、存活人数以及操作直至转运回医院的相关不良反应。结果 LMA组建立有效气道的时间明显较TT组短（P<0.05），LMA组一次插管成功率明显高于TT组（P<0.05），喉罩组院前急救存活率明显高于TT组（P<0.05），LMA组发生牙齿损伤的患者明显少于TT组（P<0.05），发生反流误吸、胃胀气与TT组比较差异无统计学意义（P>0.05）。结论采用喉罩置入与气管插管相比，喉罩置入具有一次插管成功率高、不良反应少等优点，是院前急救中一种简单易行、安全有效的紧急气道救援方式，值得推广应用。
　　목적연구후조응용우원전급구시건립긴급기도적림상효과。방법2010년6월지2012년12월100례원전심도호흡취정혹엄중호흡쇠갈적환자，수궤분위후조조（LMA조，n=50）화기관도관조（TT조，n=50）。량조분별치입후조혹삽입기관도관，기타창구조시균안상규진행。관찰기록량조환자후조치입/기관내삽관적차수、소모비적시간、존활인수이급조작직지전운회의원적상관불량반응。결과 LMA조건립유효기도적시간명현교TT조단（P<0.05），LMA조일차삽관성공솔명현고우TT조（P<0.05），후조조원전급구존활솔명현고우TT조（P<0.05），LMA조발생아치손상적환자명현소우TT조（P<0.05），발생반류오흡、위창기여TT조비교차이무통계학의의（P>0.05）。결론채용후조치입여기관삽관상비，후조치입구유일차삽관성공솔고、불량반응소등우점，시원전급구중일충간단역행、안전유효적긴급기도구원방식，치득추엄응용。
Objective To evaluate the clinical effectiveness of laryngeal in the emergency rescue airway in pre-hospital patients. Methods From June 2010 to December 2012,100 pre-hospital patients with cardiopulmonary arrest or severe respiratory failure were randomly divided into laryngeal mask airway group(group LMA,n=50)and endotracheal tube group (group TT,n=50).On the base of conventional treatment,laryngeal mask and endotracheal intubation were performed. The successful intubation ratio at one attempt,the time required for operation,the survival and the adverse reactions caused by transporting of pre-hospital rescue until back to the hospital were compared in two groups. Results The time of the effective airway establishment in group LMA was shorter than that in group TT(P<0.05). The successful intubation ratio at one attempt in group LMA was significantly higher than that in group TT(P<0.05). The survival ratio in group LMA was significantly higher than that in group TT(P<0.05).The incidence of Dental injuries in group LMA was more lower than that in group TT (P<0.05). Compared with group TT,the differences of the reflux and aspiration,flatulence occurrence were not significant (P>0.05). Conclusion Compare with endotracheal intubation,the application of laryngeal masks to establish the emergency rescue airway in pre-hospital patients has high successful intubation ratio at one attempt,less adverse reaction,etc . In this study,we conclude that the laryngeal mask airway is a simple and practicable,safe and efficient emergency-airway rescue relief way,deserve the clinical expansion.