ABSTRACT
Objective:To study the effect of sedative combined with cis-atracurium in rapid induction intubation in emergency department.Methods:From October 15, 2017 to April 15, 2019, 52 critically ill patients who needed tracheal intubation in emergency department of the People's Hospital of Changzhi were selected.And the patients were numbered according to the time sequence of enrollment, and then randomly divided into group A and group B according to the random number table, with 26 cases in each group.Group A was given sedatives combined with cis-atracurium to induce rapid intubation.Group B only received sedatives to induce intubation.The success rate of intubation, successful intubation time were compared between the two groups.Before and after endotracheal intubation, the heart rate, mean arterial blood pressure, pulse oxygen concentration and the change of catecholamine concentration were compared.Results:The success rate of intubation in group A was 100.0%, which in group B was 76.9%, the difference between the two groups was statistically significant (χ 2=12.15, P<0.05). The time required for successful intubation in group A was (5.2±0.8)s, which in group B was (8.5±2.5)s, the difference was statistically significant (χ 2=6.41, P<0.05). After intubation, the pulse oxygen concentration in group A was significantly increased compared with before intubation ( t=-7.99, P<0.05). After intubation, the heart rate, mean arterial pressure, and serum norepinephrine, dopamine levels in group A were reduced compared with before intubation, but there were no statistically significant differences (all P>0.05). The serum adrenaline level was higher compared with before intubation, but there was no statistically significant difference ( t=-1.03, P>0.05). In group B, the pulse oxygen concentration was significantly increased after intubation compared with before intubation ( t=5.74, P<0.05), but the heart rate, mean arterial pressure, and the change of blood catecholamine concentration levels in group B had no statistically significant differences ( P>0.05). Conclusion:In the airway management of critically ill patients in emergency department, the application of sedatives combined with cis-atracurium to rapidly induce intubation can improve the hypoxia symptoms of patients more rapidly and can keep patients' hemodynamics, catecholamine concentration is relatively stable, it has the characteristics of safety and efficiency.
ABSTRACT
Objective To study and explore the application effect of compound ipratropium bromide combined with budesonide in acute severe asthma.Methods 100 emergency patients with severe asthma were selected as study subjects,the patients were divided into two groups by following the principles of randomized single blind,each group had 50 cases.The control group received aminophylline treatment,the observation group was treated with budesonide combined with ipratropium bromide inhalation therapy.The clinical curative effect,relieve symptoms,condition of arterial blood gas and pulmonary function were compared between the two groups.Results The total effective rate of the observation group was 96％,which of the control group was 80％,the difference was statistically significant (x2 =6.061,P ＜ 0.05).The remission time of cough [(5.60 ± 1.35) d],expectoration [(3.54 ± 1.25) d],shortness of breath[(1.93 ± 0.87) d],wheezing [(6.09 ± 1.26) d] and other symptoms in the observation group were significantly shorter than those in the control group [(7.39 ± 1.72) d,(5.17 ± 1.54) d,(3.26 ± 1.08) d,(8.43 ±1.95) d](t =5.789,5.811,6.781,7.127,all P ＜ 0.05).After treatment,the arterial blood gas and lung function in the observation group were significantly improved (all P ＜ 0.05),which were better than those in the control group after treatment (all P ＜ 0.05).Conclusion The clinical curative effect of budesonide combined with ipratropium bromide in the treatment of patients with severe asthma is significant,it can improve the symptoms,pulmonary ventilation function and arterial blood gas.