CAJ | 학술논문

目的：探讨早期气管插管对重症脑出血患者的低氧血症及血乳酸、C反应蛋白（ CRP ）水平的影响。方法54例重症脑出血患者随机分为常规气管插管组（常规插管组，25例）和早期气管插管组（早期插管组，29例）。常规插管组患者出现呼吸衰竭时插管，而早期插管组患者出现吸氧不能纠正的低氧血症、舌根后坠或呕吐其中之一时行气管插管。在气管插管前、插管后2 h（CRP为插管后24 h），检测患者的动脉血气指标、乳酸及CRP水平；监测心率和呼吸频率。结果气管插管后与插管前比较，两组患者的血氧分压（PaO2）、二氧化碳分压（PaCO2）、氧饱和度（SaO2）及心率均明显改善，乳酸、CRP水平显著降低（均P＜0.05）。而早期插管组气管插管后的血PaO2明显高于，CRP水平明显低于常规插管组（均P＜0.05）；气管插管前的血PaO2、SaO2明显高于，乳酸、CRP水平明显低于常规插管组（均P＜0.05）。结论早期气管插管能明显改善重症脑出血患者的低氧血症，以及显著降低血乳酸和CRP水平。
목적：탐토조기기관삽관대중증뇌출혈환자적저양혈증급혈유산、C반응단백（ CRP ）수평적영향。방법54례중증뇌출혈환자수궤분위상규기관삽관조（상규삽관조，25례）화조기기관삽관조（조기삽관조，29례）。상규삽관조환자출현호흡쇠갈시삽관，이조기삽관조환자출현흡양불능규정적저양혈증、설근후추혹구토기중지일시행기관삽관。재기관삽관전、삽관후2 h（CRP위삽관후24 h），검측환자적동맥혈기지표、유산급CRP수평；감측심솔화호흡빈솔。결과기관삽관후여삽관전비교，량조환자적혈양분압（PaO2）、이양화탄분압（PaCO2）、양포화도（SaO2）급심솔균명현개선，유산、CRP수평현저강저（균P＜0.05）。이조기삽관조기관삽관후적혈PaO2명현고우，CRP수평명현저우상규삽관조（균P＜0.05）；기관삽관전적혈PaO2、SaO2명현고우，유산、CRP수평명현저우상규삽관조（균P＜0.05）。결론조기기관삽관능명현개선중증뇌출혈환자적저양혈증，이급현저강저혈유산화CRP수평。
Objective To explore the effect of early tracheal intubation on hypoxemia and level of blood lactate, C-reactive protein(CRP) in patients with severe intracerebral hemorrhage .Methods Fifty-four patients with severe intracerebral hemorrhage were divided into routine tracheal intubation (routine intubation group,n=25) and early tracheal intubation group(early intubation group,n=29) radomly.In routine tracheal intubation group, tracheal intubation was performed only when respiratory failure occurred .In early intubation group , tracheal intubation was performed as long as hypoxemia which can not be fixed by inspiring oxygen , tongue retropulsion or vomit occurred . Levels of artery blood gas analysis , lactate and CRP were tested before and after 2 h ( lactate ) or 24 h ( CRP ) of tracheal intubation .Heart rate and respiratory frequency were also monitored .Results PaO2 , PaCO2 , SaO2 and heart rate were markedly improved after intubation in both groups , levels of lactate and CRP were evidently reduced after intubation in both groups(all P<0.05).After intubation, the PaO2 of early intubation group was significantly higner and the CRP of early intubation group was significantly lower than that of routine intubation group ( all P<0.05);Before intubation, the PaO2 and SaO2 of early intubation group were significantly higher and levels of lactate and CRP were significantly lower than those of routine intubation group ( P<0.05 ) .Conclusion Early tracheal intubation can improve hypoxemia and reduce the level of lactate and CRP in patients with severe intracerebral hemorrhage .