人工气道建立并发鼻窦炎的转归

Outcome of Sinusitis in Patients with Artificial Airway

目的:探讨行人工气道建立时鼻窦炎并发症在人工气道解除后近期的转归。方法:将84例需要建立人工气道、机械通气患者随机分为经鼻气管插管(经鼻)组49例和经口气管插管(经口)组34例。所有患者在拔管前行鼻窦CT扫描。确诊为鼻窦炎者,于拔管后第7天复查鼻窦CT。结果:49例拔管前确诊为鼻窦炎者,经鼻组38例,其中放射性鼻窦炎30例(78.9%),感染性鼻窦炎8例(21.1%);经口组11例,放射性鼻窦炎8例(72.7%),感染性鼻窦炎3例(27.3%)。复查鼻窦CT显示经鼻组18例痊愈,14例好转,6例未愈。其中放射性鼻窦炎17例痊愈,10例好转,3例未愈;感染性鼻窦炎1例痊愈,4例好转,3例未愈。经口组3例痊愈,5例好转,3例未愈。其中放射性鼻窦炎2例痊愈,4例好转,2例未愈;感染性鼻窦炎1例痊愈,1例好转,1例未愈。结论:鼻窦炎是人工气道建立的并发症。人工气道解除后,多数患者鼻窦炎痊愈或好转,无需局部处理。

Objective： To investigate the clinical outcome of sinusitis in patients with artificial airways. Methods： In a prospective study, patients required mechanical ventilation were randomly allocated to two groups, nasotracheal intubation group （n=49） and orotracheal intubation group （n=34）. All patients performed sinus computed tomography （CT） scans before removing intubation. And patients who were diagnosed sinusitis were rechecked sinus CT scans seven days postoperatively. Results： Forty-nine patients were diagnosed as sinusitis before removing intubation, including 38 patients in nasotracheal intubation group （30 cases with radiologic sinusitis and 8 cases with infectious sinusitis） and 11 patients in orotracheal intubation group （8 cases with radiologic sinusitis and 3 cases with infectious sinusitis）. The sinus CT scan showed that 18 patients were recovered,14 patients were improved and 6 patients were ineffective in nasotracheal intubation group. In patients with radiologic sinusitis, 17 patients were recovered,10 patients were improved and 3 patients were ineffective. In patients with infectious sinusitis, 1 patient was recovered,4 patients were improved and 3 patients were ineffective. There were 3 patients were recovered,5 patients were improved and 3 patients were ineffective in orotracheal intubation group. In these patients, 2 were recovered,4 were improved and 2 ineffective in those with radiologic sinusitis, and 1 was recovered,1 was improved and 1 ineffective in patients with infectious sinusitis. Conclusion： Sinusitis is a complication of artificial airways. Most patients who were diagnosed with sinusitis recovered or improved after removing intubation without treatment.