摘要
目的研究便携式纤维支气管镜引导经鼻气管插管在抢救呼吸衰竭患者中的应用效果。方法经医院医学伦理委员会批准,选择2018年4月至2019年3月89例呼吸衰竭患者,采用隐匿数字随机法分为两组,45例采用传统麻醉喉镜经口气管插管行机械通气的患者为经口插管组,44例采用便携式纤维支气管镜引导经鼻气管插管行机械通气的患者为经鼻插管组,比较两组一次插管成功率、抢救成功率、插管时间、插管成功至机械通气历时、机械通气时间、非计划性拔管率、住院时间,记录两组插管过程并发症。结果经鼻插管组插管用时(131.7±13.4)s、机械通气时间(107.2±9.2)h、住院时间(10.8±1.7)d短于经口插管组的(188.2±19.6)s、(186.9±20.4)h、(15.4±2.2)d,差异均有统计学意义(P<0.05)。经鼻插管组一次插管成功率100%、抢救成功率95.45%,高于经口插管组的80%、84.44%;非计划拔管率为0.00%,低于经口插管组的13.33%,差异均有统计学意义(P<0.05)。经鼻插管组并发症发生率为47.73%,经口插管组为48.89%,两组差异无统计学意义(P>0.05)。结论便携式纤维支气管镜携带方便,引导经鼻气管插管抢救ARF可提高一次插管成功率,缩短插管时间,提高疗效,建议推广应用。
Objective To study the application of portable fiberoptic bronchoscopy guided transnasal tracheal intubation in patients with acute respiratory failure(ARF).Methods From April 2018 to March 2019,89 patients with ARF were randomly divided into two groups using hidden numbers under the approval of Medical ethics committee of our hospital;among whom 45 cases received traditional anesthesia laryngoscopic oral intubations as traditional group,and 44 patients received portable fiber guidance nasal tracheal intubation as nasal group.The success rate of intubation,rescue success rate,the intubation time,interval between successful intubation and mechanical ventilation,mechanical ventilation time and unscheduled decannulation rate,hospital stay,and intubation complications were compared between the 2 groups.Results The intubation time[(131.7±13.4)s],mechanical ventilation time[(107.2±9.2)h],and hospital stay[(10.8±1.7)d]in the nasal group were significantly shorter than those in the traditional group[(188.2±19.6)s,(186.9±20.4)h and(15.4±2.2)d,respectively,P<0.05].The success rate of first intubation and rescue rates were 100% and 95.45%,respectively,in the nasal group,which were significantly higher than those in the traditional group(80% and 84.44%,respectively,P<0.05);and the unplanned extubation rate was 0.00%,significantly lower than that in the traditional group(13.33%,P<0.05).The incidence of complications was 47.73%in the nasal group and 48.89% in the traditional group,with no significant difference between them(P>0.05).Conclusion Portable fiberoptic bronchoscope is convenient to carry,for guiding transnasal tracheal intubation in patients with ARF.It can improve the success rate of primary intubation,shorten the intubation time,and improve the curative effect.
作者
李勋济
柳俊杰
欧阳长法
冯俊亚
匡敏
尹玲玲
LI Xun-ji;LIU Jun-jie;OUYANG Chang-fa;FENG Jun-ya;KUANG Min;YIN Ling-ling(Department of Respiratory Medicine,Jiujiang Third People's Hospital,Jiujiang 332000,Jiangxi,China)
出处
《广东医学》
CAS
2020年第6期580-584,共5页
Guangdong Medical Journal
基金
江西省卫生计生委科技计划项目(20187138)。
关键词
便携式纤维支气管镜
经鼻
气管插管
呼吸衰竭
抢救
portable fiberoptic bronchoscope
by the nose
endotracheal intubation
respiratory failure
the rescue
