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目的观察纤维支气管镜下经鼻气管插管在危重病患者抢救中的应用效果。方法选择2009年10月—2012年11月收治的需要建立人工气道,并且接受机械通气的危重病患者80例,随机分为观察组和对照组各40例。观察组纤维支气管镜下经鼻气管插管,对照组经口气管插管。记录两组插管所用时间、导管管径、留置时间、口腔护理时间及并发症。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组插管所用时间、导管管径、留置时间、口腔护理时间[(52.4±5.8)s、(6.1±0.4)mm、(20.3±5.1)d、(1.5±0.5)min/次]与对照组[(48.2±5.2)s、(7.5±0.5)mm、(12.1±3.9)d、(3.1±0.8)min/次]比较差异均有统计学意义(均P<0.05)。并发症发生率观察组5.0%,对照组17.5%,两组比较差异无统计学意义(P>0.05)。结论纤维支气管镜下经鼻气管插管与经口气管插管相比,虽然插管所用时间较长,但导管管径小、留置时间长、口腔护理所用时间短,值得在危重病患者抢救中推广应用。
Objective To observe the effect of nasobasal endotracheal intubation in the treatment of critically ill patients by fiberoptic bronchoscopy. Methods Eighty critically ill patients who needed to establish artificial airway and received mechanical ventilation were selected from October 2009 to November 2012 and were randomly divided into observation group and control group with 40 cases each. The observation group was treated with endotracheal intubation through bronchoscopy and the control group with intubation. The duration of intubation, catheter diameter, indwelling time, oral care time and complication were recorded. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The intubation time, catheter diameter, indwelling time, oral care time [(52.4 ± 5.8) s, (6.1 ± 0.4) mm, (20.3 ± 5.1) d and (1.5 ± 0.5) min / The difference between the control group [(48.2 ± 5.2) s, (7.5 ± 0.5) mm, (12.1 ± 3.9) d, (3.1 ± 0.8) min / time] was statistically significant (all P <0.05). The incidence of complications was 5.0% in the observation group and 17.5% in the control group, with no significant difference between the two groups (P> 0.05). Conclusion Compared with orotracheal intubation, the nasal endotracheal intubation with bronchofibroscope has a shorter catheter diameter, longer indwelling time and shorter time of oral care, which is worth to be used in emergency treatment of critically ill patients Promote the application.