不同气管插管方法用于急危重症患者抢救的临床效果比较

Comparison of clinical effect between orotracheal intubation and nasotracheal intubation with bronchofibroscope in critical patients

目的比较采用经口气管插管与经鼻气管插管方法用于急危重患者的临床疗效。方法回顾性分析需要行有创机械通气的急危重患者79例,分为经口气管插管组(OI)和经鼻气管插管组(BNI),其中OI组42例,BNI组37例,对2组患者的一次插管成功率,一次成功插管时间,呼吸机治疗24h后血气变化,脱管率,气管导管留置时间,每次口腔护理时间,行插管后的并发症情况及死亡例数等进行统计和比较。结果 2组一次插管成功率、脱管例数、呼吸机治疗24h后血气变化、发生呼吸机相关肺炎、痰痂阻管、鼻衄、更换插管方式、死亡例数等比较差异无统计学意义(P>0.05),而OI组的一次成功插管时间、气管导管留置时间、每次口腔护理时间、口腔溃疡发生率与BNI组比较差异有统计学意义(P<0.05)。结论经口插管操作快捷,而经鼻插管患者耐受性好,易于固定,便于口腔护理,导管保留时间长。

Objective To compare the clinical effect between orotracheal intubation（OI） and nasotracheal intubation with bronchofibroscope （BNI） in critical patients. Methods 79 cases of critical patients who had required invasive mechanical ventilation in EICU were retrospectively analyzed. OI group had 42 cases, BNI group had 37 cases. The success rate of first intubation, successful intubation time, blood gas changes after twenty-four hour treatment, loss rate of pipe, detaining time, mouth care of time, complication and death cases were compared. Results The difference of success rate of first intubation,loss rate of pipe, blood gas changes after twenty-four hour treatment, Entilator-associated pneumonia, sputum scab resistance tube, nasal bleeding, replace the way of intubation, death cases between two groups had no significant （ P 〉 0.05 ）, The difference of successful intubation time, detaining time, mouth care of time, incidence of oral ulcer between two groups had significant （ P 〈 0. 05 ）. Conclusion OI is easier and faster to operate than BNI, but BNI is more endurable, easier fixed, easier mouth nursing and longer retaining time.