预防性气管插管在抢救钩吻中毒的作用分析

摘要

Objective To investigate the first-aid methods for patients with gelsemism.Methods The application of preventive tracheal intubation were given in the emergency rescue in 20 cases patients with gelsemism.Then gived the mechanical ventilation with the SIMV mode.the breathing rate were 16-18 times/min,and the tidal volume was 6-8ml/kg.3 cases of pulmonary edema were added PEEP 5-10cm H20. On the basis of stable respiratory cycle, 14 cases were given gastric lavaged with water and catharsised by giving 20% mannitol,6 cases were catharsised by giving 20% mannitol only.Results 18 cases were cured (18/20) and 2 cases were dead(2/20) after the treatment for 1-3 weeks.The cured one were all smoothly off-line,and the mechanical ventilation time were for 1.5-8.3(4.6 ± 2.2)d.And the direct cause of death were respiratory failure. Conclusions Preventive tracheal intubation is the primary rescue measures for the gelsemism.%目的 探讨钩吻中毒的急救方法.方法 在急诊中应用预防性气管插管抢救钩吻中毒患者20例.立即给予呼吸、心电、血氧饱和度等监护.均予预防性气管插管,连接呼吸机机械通气治疗,通气模式SIMV,呼吸频率16～18次/min,潮气量6～8 ml/kg,3例肺水肿者加用PEEP5～10cmH2O.在稳定呼吸循环的同时,14例给予清水洗胃20%甘露醇导泻,6例仅予20%甘露醇导泻.结果 本组经1～3周治疗.治愈出院18例,死亡2例.治愈者均顺利脱机,机械通气时间(4.6±2.2)d.2例死亡患者食物残渣显色反应均为强阳性,直接死亡原因均为呼吸衰竭.结论 预防性气管插管是抢救钩吻中毒的首要措施.