两种气管插管方法在老年慢性阻塞性肺疾病抢救中的比较

摘要

Objective To explore the effectiveness of fiberbronchoscope guided transnasal tracheal intubation and tran-soral tracheal intubation in rescuing elderly patients with chronic obstructive pulmonary disease. Methods A total of 106 patients with chronic obstructive pulmonary disease concurrent with respiratory failure treated in the intensive care unit of our hospital from June 2006 to April 2015 were selected and randomly divided into the control group and the observation group according to the hospital admission number sequence.The control group used transoral tracheal intu-bation for rescue treatment and the observation group used fiberbronchoscope guided transnasal tracheal intubation for rescue treatment.The improvement of clinical indicators,one time intubation success rates,intubation complications and accidental extubation rates between two groups of patients were compared. Results The one time intubation success rate of observation group was 88.68% and that of control group was 56.60%(P<0.05);the incidences of complications of the observation group and the control group was 7.55% and 32.08% respectively (P<0.05).The observation group was lower than the control group in the intubation time and accidental extubation rate (P<0.05). Conclusion Fiberbroncho-scope guided transnasal tracheal intubation causes few complications,has high one time intubation success rate and causes less accidental extubation,thereby worthy of further promotion and application.%目的：探讨纤维支气管引导经鼻气管插管、经口气管插管抢救治疗老年慢性阻塞性肺疾病的有效性。方法选取2006年6月~2015年4月到我院重症医学科接受治疗的106例慢性阻塞性肺疾病并发呼吸衰竭患者，按入院编号顺序，随机分为对照组和观察组。对照组采用经口气管插管进行抢救治疗，观察组采用纤维支气管引导经鼻气管插管进行抢救治疗，对比两组患者临床指标改善情况、一次插管成功率、插管并发症和意外拔管率。结果观察组一次插管成功率为88.68%，对照组为56.60%(P<0.05)；观察组与对照组并发症发生率分别为7.55%、32.08%(P<0.05)；观察组插管时间短于对照组(P<0.05)；观察组意外拔管率低于对照组(P<0.05)。结论纤维支气管镜引导经鼻气管插管并发症少、一次插管成功率高、意外拔管少，值得进一步推广应用。