经口气管插管和经鼻气管插管在儿童重症监护室患儿中的应用效果分析

Analysis on the Application Effects of Orotracheal Intubation and Nasotracheal Intubation in Children in Intensive Care Unit

目的分析比较经口气管插管与经鼻气管插管在儿童重症监护室患儿中的应用效果。方法选择我院2016年12月至2017年10月收治的155例重症监护室患儿,按照入院先后分为对照组78例与观察组77例。对照组患儿采用经口气管插管,观察组患儿采用经鼻气管插管,比较两组的气管插管结局。结果对照组患儿的一次性插管成功率和治疗期间意外脱管率均显著高于观察组,导管留置时间和平均插管成功时间均显著短于观察组(均P <0.05)。插管24 h后,两组的PaO2均显著升高, PaCO2均显著下降,但组间比较差异均无统计学意义(P>0.05)。插管后,观察组的不良事件发生率显著低于对照组(P <0.05)。结论经鼻气管插管与经口气管插管的效果相近,但经口气管插管的一次性成功率更高,而经鼻气管插管的不良事件发生率和意外脱管率较低,两种插管方式应根据患儿的实际情况具体选择。

Objective To analyze and compare the effects of orotracheal intubation and nasotracheal intubation in children in intensive care unit （ICU）. Methods 155 cases of children admitted to ICU from December 2016 to October 2017 were selected. According to their admission, all cases were divided into two groups. 78 cases of the control group received orotracheal intubation, and 77 cases of the observation group received nasotracheal intubation. The outcomes of tracheal intubation of the two groups were compared. Results The success rate of one-time intubation and the rate of accidental dissection during treatment of the control group were significantly higher than those of the observation group, and the catheter indwelling time and the average intubation success time were significantly shorter than those of the observation group （P 〈0.05）. After intubation for 24 h, both groups had significantly increased PaO2 and decreased PaCO2, but there was no significant difference between the two groups （P 〉0.05）. After intubation, the incidence of adverse events of the observation group was significantly lower than that of the control group （P 〈0.05）. Conclusions The effect of nasotracheal intubation is similar to orotracheal intubation, but the one-time success rate of orotracheal intubation is higher, and the incidence of adverse events and the rate of accidental dissection ofnasotracheal intubation are lower. The intubation method should be selected according to the actual situation of the child.