558例紧急气管插管患者预后分析
1. 厦门市第三医院, 麻醉科, 福建厦门 361100
2. 厦门市第三医院, 医教部, 福建厦门 361100
3. 福建医科大学附属协和医院, 麻醉科, 福建福州 350001
| 摘 要： | 目的：观察分析行紧急气管插管住院患者的预后及影响因素。方法：收集2015年1月-2018年12月行紧急气管插管的住院患者558例，回顾性分析患者的临床资料，首要观察目标是插管后30d院内死亡率；次要观察指标是插管原因、死亡原因、插管操作场所（外科或内科病房）和时间（班内或班外时间）、是否入住ICU等。统计分析院内死亡患者与存活患者上述指标的差异以及影响死亡率的风险因素。结果：558例中，院内死亡率为66.8%，呈逐年下降趋势。最常见的插管原因是呼吸、心血管和神经系统疾病。内科病房接受紧急插管患者的比例和死亡率均显著高于外科病房（P<0.05）；院内死亡患者与存活患者班内、外插管时间差别无统计学意义（P=0.36）。院内死亡患者的ICU入住率显著低于存活患者（P=0.00）。存活患者中，插管后行心肺脑复苏者比例显著低于院内死亡患者（P=0.04）。插管后死亡患者中，插管前平均动脉压和静脉血氧饱和度均显著低于存活患者（P=0.00），休克指数显著高于存活患者（P=0.00）。结论：行紧急气管插管患者预后较差，院内死亡率高达66.8%；外科病房插管及插管后ICU入住是降低院内死亡率的风险因素。 |
| 关 键 词： | 紧急气管插管; 预后; 死亡率 |
| DOI： | 10.57237/j.wjcm.2023.02.004 |
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收稿日期: 2023-03-26
接受日期: 2023-06-05
在线出版日期: 2023-06-15
Prognostic Analysis of 558 Emergency Tracheal Intubation Patients
1. Department of Anesthesiology, Xiamen Third Hospital, Fujian University of Traditional Chinese Medicine, Xiamen 361100, China
2. Department of Medical Education, Xiamen Third Hospital, Fujian University of Traditional Chinese Medicine, Xiamen 361100, China
3. Department of Anesthesiology, Union Hospital, Fujian Medical University, Fuzhou 350001, China
| Abstract: | Objective: To observe and analyze the prognosis and factors of hospitalized patients with emergency tracheal intubation. Methods: From January 2015 to December 2018, the hospitalized patients undergone emergency endotracheal intubation in Union Hospital Affiliated to Fujian Medical University were retrospectively analyzed. The primary goal was in-hospital mortality 30 days after intubation; the secondary observation indicators were intubation causes, causes of death, intubation operation site (surgical ward or medical ward) and time (daytime or off-hours), ICU admission, etc. The differences of the above indexes and the risk factors of mortality were analyzed. Results: 558 patients with emergency endotracheal intubation were included in the study. The hospital mortality rate was 66.8%, showing a downward trend year by year; the most common causes of intubation were respiratory system diseases, cardiovascular system and nervous system diseases. The proportion of patients receiving emergency intubation in medical ward was significantly higher than that in surgical ward, and the mortality was also significantly higher than that in surgical ward (P<0.05); there was no significant difference in the intubation time between the dead patients and the surviving patients (P=0.36). The ICU occupancy rate of patients who died in hospital was significantly lower than that of patients who survived (P=0.00). Of the survival patients, the rate of cardiopulmonary cerebral resuscitation after intubation decreased significantly (P=0.04). In the death patients after intubation, the mean arterial pressure and venous oxygen saturation before intubation were significantly lower than those in the survival patients (P=0.00), and the shock index was significantly higher than that in the survival patients (P=0.00). Conclusion: The prognosis of patients with emergency endotracheal intubation is poor; The in-hospital mortality is as high as 66.8%; Intubation in surgical ward and ICU occupancy after intubation both are the risk factors to reduce the in-hospital mortality. |
| Keywords: | Emergency Endotracheal Intubation; Prognosis; Mortality |
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