妊娠晚期急性呼吸衰竭患者纤维支气管镜下经鼻实施气管插管的临床效果分析

Analysis on clinical effect of transnasal tracheal intubation under fiber bronchoscope in patients with acute respiratory failure during the third trimester of pregnancy

目的：研究纤维支气管镜下经鼻实施气管插管对妊娠晚期急性呼吸衰竭患者的临床效果。方法：将该院2010年1月～2013年1月收治的35例妊娠晚期急性呼吸衰竭患者作为研究对象，对其进行纤维支气管镜下经鼻实施气管插管治疗，观察治疗效果。结果：患者治疗后肺功能各项指标均有不同程度的改善，与治疗前相比差异有统计学意义（t=4．8660，6．4549，17．5286，4．2960，3．1822；P=0．0000，0．0000，0．0000，0．0015）；患者治疗后血氧分压上升，二氧化碳分压显著下降，呼吸频率下降，逐渐平稳；上述指标与治疗前相比差异具有统计学意义（t=7．1172，6．1950，8．1717；P=0．0000）；患者治疗后血清内白细胞介素-32、肿瘤坏死因子-、单核细胞趋化蛋白一l等炎性因子水平明显下降，与治疗前相比差异有统计学意义（t=4．9481，14．0407，9．9639；P=0．0000）。结论：气管插管后患者肺功能改善，二氧化碳分压明显下降，血氧分压增加，呼吸频率稳定，且血清炎性因子水平下降，具有一定的临床意义。

Objective： To research the clinical effect of transnasal tracheal intubation under fiber bronchoseope in patients with acute respiratory failure during the third trimester of pregnancy. Methods ： Thirty - five patients with acute respiratory failure during the third trimester of pregnancy treated in the hospital from January 2010 to January 2013 were selected as study objects, then transnasal tracheal intubation under fiber bronchoscope was performed, the curative effect was observed. Results ： After treatment, the various indexes of pulmonary function were improved to varying degrees, compared with before treatment, there were statistically significant differences （ t = 4. 866 0, 6. 454 9, 17. 528 6, 4. 296 0, 3. 182 2; P =0. 000 0, 0. 000 0, 0. 000 0, 0. 001 5） ; after treatment, partial pressure of blood oxygen increased, partial pressure of carbon dioxide decreased, respiratory rate decreased and gradually smooth; compared with before treatment, there were statistically significant differences in the above - mentioned indexes （t = 7. 117 2, 6. 195 0, 8. 171 7; P = 0. 000 0） ; after treatment, the levels of serum interleukin - 32, tumor necrosis factor - ct and monocyte chemoattractant protein - 1 decreased significantly, compared with before treatment, there were statistically significant differences （t = 4. 948 1, 14. 040 7,9. 963 9; P = 0. 0000） . Conclusion： After intubation, pulmonary function is improved, partial pressure of carbon dioxide decreases, partial pressure of blood oxygen increases, respiratory rate is stable, and serum inflammatory factors levels decrease, which has a certain clinical significance.