纤支镜引导经鼻气管插管与经口气管插管在抢救急性呼吸衰竭患者中的应用分析

Application of Nasotracheal Intubation and Orotracheal Intubation Guided by Fiberoptic Bronchoscope in Rescuing patients with Acute Respiratory Failure

目的:探究纤支镜引导经鼻与经口气管插管在抢救急性呼吸衰竭患者中的应用。方法:回顾性分析2013年1月-2018年12月本院收治的急性呼吸衰竭患者100例的临床资料。按气管插管方法将其分为对照组(n=50)和观察组(n=50)。对照组采用纤支镜引导经口气管插管,观察组给予纤支镜引导经鼻气管插管。比较两组气管插管成功所需时间、一次插管成功例数、血气分析首次达标所需时间、达到撤机条件所需时间、插管前后气管插管相关指标(pH、PaO2、PaCO2、RR、HR)、并发症发生情况。结果:观察组一次插管成功率高于对照组,气管插管成功所需时间、血气分析首次达标所需时间、达到撤机条件所需时间均短于对照组,差异均有统计学意义(P<0.05);插管前和插管后12、24 h,两组pH值、PaO2、PaCO2、RR、HR水平比较,差异均无统计学意义(P>0.05),插管后72 h,观察组pH值、PaO2、PaCO2、RR、HR水平均优于对照组,差异均有统计学意义(P<0.01);观察组并发症发生率低于对照组(P<0.05)。结论:纤支镜引导经鼻气管插管在治疗急性呼吸衰竭患者中,可以提高一次性插管成功率,降低并发症发生率,改善呼吸功能,值得在临床推广使用。

Objective:To explore the application of nasotracheal intubation and orotracheal intubation guided by fiberoptic bronchoscope in rescuing patients with acute respiratory failure.Method:The clinical data of 100 patients with acute respiratory failure admitted to our hospital from January 2013 to December 2018 were retrospectively analyzed.According to the method of tracheal intubation,they were divided into control group(n=50)and observation group(n=50).The control group was treated with orotracheal intubation guided by fiberoptic bronchoscope,and observation group was given nasotracheal intubation guided by fiberoptic bronchoscope.The time required for successful tracheal intubation,successful cases of one-time intubation,the time required for the first time to reach the standard of blood gas analysis,the time required to reach the withdrawal condition,the related indicators of tracheal intubation before and after intubation(pH,PaO2,PaCO2,RR,HR),and the occurrence of complications between two groups were compared.Result:The successful cases of one-time intubation in observation group was higher than that of control group,the time required for successful tracheal intubation,the time required for the first time to reach the standard of blood gas analysis and the time required to reach the withdrawal condition in observation group were shorter than those of control group,the differences were statistically significant(P<0.05).Before intubation and 12 and 24 hours after intubation,the levels of pH,PaO2,PaCO2,RR and HR in two groups were compared,the differences were not statistically significant(P>0.05). 72 hours after intubation,the levels of pH,PaO2,PaCO2,RR and HR in observation group were better than those of control group,the differences were statistically significant(P<0.01).The incidence of complications in observation group was lower than that of control group(P<0.05).Conclusion:Nasotracheal intubation guided by fiberoptic bronchoscope in patients with acute respiratory failure can improve the success of one-time intubation rate,reduce the incidence of complications,improve respiratory function,which is worthy of clinical application.