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【目的】探讨纤支镜引导下经鼻气管插管联合肺灌洗治疗急性呼吸衰竭的临床疗效。【方法】选择本院符合急性呼吸衰竭诊断标准的180例患者按插管方式不同分为两组，观察组90例行纤维支气管镜引导下经鼻气管插管及肺灌洗治疗，对照组90例予喉镜经口气管插管，比较两组患者的临床疗效。【结果】观察组和对照组气管插管时间分别为（2．2±1．2）min、（3．1±2．3）min ，机械通气时间分别为（105．38±45．89）h、（197．32±89．13）h ，住院时间分别为（9．68±2．89）d、（15．88±2．12）d ，观察组均明显短于对照组，且两组相比较差异有显著性（ P ＜0．05）；观察组90例全部一次插管成功，对照组74例一次插管成功，一次插管成功率观察组（100％）明显高于对照组（82．22％），观察组抢救成功率（94．44％）明显高于对照组（85．56％），且两组相比较差异有显著性（ P ＜0．05）。【结论】纤支镜引导下经鼻气管插管联合肺灌洗治疗较传统喉镜经口气管插管能更快速、安全、高效地抢救急性重症呼吸衰竭患者。“,”[Objective] To explore the clinical efficacies of fiber bronchoscope‐guided nasotracheal intubation plus lung lavage in the treatment of acute respiratory failure (ARF) .[Methods]A total of 180 patients fulfilled the stand‐ard diagnostic criteria of ARF were divided into treatment and control groups ( n=90 each) .The treatment group underwent fiberoptic bronchoscope‐guided nasotracheal intubation and lung lavage .And the control group had laryn‐goscopic orotracheal intubation .And the clinical efficacies were compared for two groups .[Results] The intubation durations of treatment and control groups were 2 .2 ± 1 .2 and 3 .1 ± 2 .3 min ,mechanical ventilation time 105 .38 ± 45 .89 and 197 .32 ± 89 .13 hours and hospitalization time 9 .68 ± 2 .89 and 15 .88 ± 2 .12 days respectively .The treat‐ment group was shorter than the control group ( P<0 .05) .Intubation was all successful at one time for 90 cases in treatment group versus 74 cases in control group .The intubation success rate of treatment group was significantly higher than that of control group (100% vs 82 .22% ) .And the rescue success rate of treatment group was signifi‐cantly higher than that of control group (94 .44% vs 85 .56% ,P<0 .05) .[Conclusion]As compared with traditional laryngoscopic orotracheal intubation ,fiberoptic bronchoscope‐guided nasotracheal intubation plus lung lavage is more rapid ,safer and efficient for ARF patients .