摘要
目的探究可视喉镜联合纤维支气管镜在颅脑外伤患者急救气管插管中的应用及对肺部感染的影响。方法选取义乌市中心医院2020年1-12月收治的颅脑外伤患者105例为观察对象,采用随机数字表法分为观察组(55例)和对照组(50例)。对照组借助可视喉镜进行气管插管,观察组联合使用纤维支气管镜进行气管插管。观察两组声门暴露情况、插管情况、生命体征变化、住院期间肺部感染率以及相关并发症发生率。结果观察组声门暴露情况优于对照组(Z=4.29,P<0.001);观察组一次插管成功率[96.36%(53/55)]高于对照组[82.00%(41/50)](χ^(2)=5.76,P<0.05),插管次数[(1.07±0.53)次]及插管总耗时[(85.12±15.36)s]均少于对照组[(1.92±0.74)次、(106.13±16.34)s](t=6.81、6.79,均P<0.001);观察组插管期间患者平均动脉压、心率变化幅度均小于对照组,插管完成后血氧饱和度上升幅度大于对照组(均P<0.05);观察组肺部感染率[10.91%(6/55)]低于对照组[30.00%(15/50)](χ^(2)=5.96,P<0.05);观察组气管插管并发症发生率[5.45%(3/55)]低于对照组[18.00%(9/50)](χ^(2)=4.07,P<0.05)。结论将可视喉镜联合纤维支气管镜应用于颅脑外伤患者急救气管插管中,可提高一次插管成功率,减少反复插管操作,缩短插管时间,有助于维持患者生命体征平稳,预防肺部感染和并发症的发生,具有一定的临床应用价值。
Objective To investigate the application of a video laryngoscope combined with a fiberoptic bronchoscope in emergency endotracheal intubation and its effects on pulmonary infection in patients with craniocerebral trauma.Methods A total of 105 patients with craniocerebral trauma who received treatment in Yiwu Central Hospital from January 2020 to December 2020 were included in this study.They were randomly allocated to undergo endotracheal intubation with a video laryngoscope(control group,n=50)or a video laryngoscope combined with a fiberoptic bronchoscope(observation group,n=55).Glottic exposure,intubation,vital signs,lung infection rate during hospitalization,and incidence of complications were monitored/determined in each group.Results Glottic exposure in the observation group was superior to that in the control group(Z=4.29,P<0.001).First-pass success rate was significantly higher in the observation group than in the control group[96.36%(53/55)vs.82.00%(41/50),χ^(2)=5.76,P<0.05].The number of intubation attempts and the time to successful intubation were(1.07±0.53)times and(85.12±15.36)seconds,respectively in the observation group,which were significantly less or shorter than those in the control group[(1.92±0.74)times,(106.13±16.34)seconds,t=6.81,6.79,both P<0.001].The changes in mean arterial pressure and heart rate during intubation were less in the observation group than in the control group(both P<0.05).The amplitude of increase in blood oxygen saturation after intubation was greater in the observation group than in the control group(P<0.05).Lung infection rate was significantly lower in the observation group than in the control group[10.91%(6/55)vs.30.00%(15/50),χ^(2)=5.96,P<0.05].The incidence of complications was significantly lower in the observation group than in the control group[5.45%(3/55)vs.18.00%(9/50),χ^(2)=4.07,P<0.05].Conclusion Application of a video laryngoscope combined with a fiberoptic bronchoscope in emergency endotracheal intubation can increase the first-pass success rate,reduce repeated intubation attempts,shorten time to successful intubation,help to maintain stable vital signs,prevent lung infection and complication.Therefore,the combined method is of clinical application value.
作者
邱伟勇
陈丽丹
朱志南
Qiu Weiyong;Chen Lidan;Zhu Zhinan(Department of Critical Care Medicine,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2022年第3期349-353,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省义乌市科研计划项目(19-3-127)。
关键词
颅脑损伤
插管法
气管内
喉镜
支气管镜
光学纤维
生命体征
感染
Craniocerebral trauma
Intubation,intratracheal
Laryngoscopes
Bronchoscopes
Optical fibers
Vital signs
Infection
