经鼻盲探气管插管术在急诊创伤患者中的临床应用效果分析

Clinical application effect of nasal blind tracheal intubation in emergency trauma patients

目的探讨在急诊创伤患者抢救中应用经鼻盲探气管插管术（BNTI）的临床效果及价值。方法回顾性分析2013年12月至2015年12月我院收治的48例急诊创伤患者的临床资料,抢救过程中均行BNTI术,观察患者的插管即刻反应、插管成功率、插管辅助法。结果 48例患者的意识状态包括GCS〈8分、GCS8~10分、无意识障碍;1次插管成功率为52.1%,插管失败率16.7%。24例患者出现插管即刻反应,包括轻度呛咳、剧烈呛咳与屏气、有吞咽反射,插管成功率分别为100.0%、0.0%、0.0%。首次插管不成功16例,使用套囊充气法9例,插管成功率88.9%;使用非套囊充气法7例,插管成功率85.7%。结论在急诊创伤患者抢救中应用BNTI术,效果良好,适用性、有效性高,但需注意患者的意识状态、咽喉反射,积极选用插管辅助法,为手术顺利进行奠定基础。

Objective To investigate the clinical effect and value of the application of nasal blind tracheal intubation（ BNTI） in the emergency treatment of trauma patients. Methods A retrospective analysis of the clinical data of December 2015 2013 to December 2004 in our hospital were of 48 cases of emergency trauma patients,rescued process were performed BNTI and observation of patients with immediate responses to tracheal intubation,intubation success rate of intubation and assisted method. Results 48 cases of patients with state of consciousness including GCS 8 points,GCS8 ~ 10,disturbance of consciousness,the first intubation success rate of 52. 1% and failed intubation rate was 16. 7%. 24 cases of immediate responses to tracheal intubation in patients,including mild cough,acuteness choke to cough and breath,swallowing reflex,the success rate of catheterization was 100%,0. 0%,0. 0% respectively. First intubation was unsuccessful in 16 cases,using the cuff method in 9 cases,success rate of intubation was 88. 9%; by using non cuff inflation method in 7 cases,the success rate of intubation was 85. 7%. Conclusions Application of BNTI in trauma patients in emergency has good effect,applicability and validity is high,but we need to pay attention to the patient＇s state of consciousness and pharyngeal reflex,we should actively choose intubation assisted method to lay a foundation for the smooth operation.