摘要
目的探讨纤支镜引导下经鼻气管插管有创与无创序贯抢救Ⅱ型呼吸衰竭的临床价值。方法对我院2005年4月至2006年8月救治的Ⅱ型呼吸衰竭(重症)60例患者资料作回顾性分析,对纤支镜引导经鼻气管插管与经口喉镜明视插管有创、无创序贯进行机械通气各自的成功率、留管时间、气管切开率、拔管率及患者预后情况进行比较。结果置管时间经鼻插管组9.4±5.5 d,经口插管3.5±1.4 d;气管切开率:经鼻插管组6.7%,经口插管组46.7%;拔管率:经鼻插管组93.3%,经口插管组40.0%,(P 均<0.01),差异均有显著性。结论经口气管插管或气管切开的缺点是患者往往不能耐受或接受;纤支镜引导下经鼻气管插管有创、无创序贯治疗抢救Ⅱ型呼吸衰竭,患者耐受性好,留管时间长,拔管率高,同时可避免或减少气管切开率,具有快速、准确、安全,能尽早撤机,减少呼吸机相关性肺炎等并发症之优点,值得临床推广。
Objective To evaluate the clinical value of Invasive and noninvasive sequential pernasal tracheal intubation guided by fiberbronchoscope to rescue type Ⅱ respiratory failure. Methods To total 60 patients with type Ⅱ respiratory failure were treated with sequential mechanical ventilation from April 2005 to August 2006 were divided into two groups ： pernasal group tracheal intubation was guided by fiberbronchoscope and peroral group in which tracheal intubction was operated under direct vision by laryngoscope. The clinical effects of two groups were compared were compared on intubation achievement ratio, retaining time, extubate ratio, incision of trachea ratio and symptom improvement Results The intubation - retaining time in pernasal group （9.4 ± 5.5 d） can be prolonged significantly in contrast to peroral group（3.5± 1.4 d） （ P 〈 0. 01 ）. The extubate ratio in pernasal group（ 93.3% ） increased significantly in contrast to peroral group （40.0%） （ P 〈0.01 ）. Compared with peroral group （46. 7% ） ,the incision of trachea ratio in pernasal group （6.7%） decreased marked- ly （ P 〈 0.01 ）. Conclusion Invasive and noninvasive sequential pernasal tracheal intubation guided by fiberbronchoscope to rescue type Ⅱ respiratory failure could prolonged the intubation - retaining time, increase the extubate ratio and decrease the incision of trachea ratio. These effectives might elevate the rescue achievement ratio.
出处
《临床急诊杂志》
CAS
2007年第2期67-69,共3页
Journal of Clinical Emergency
关键词
纤维支气管镜
插管法
呼吸衰竭
序贯机械通气
Fiberbronchoscope
Tracheal intubation
Respiratory failure
Sequential mechanical ventilation
