经鼻盲探气管插管在抢救呼吸衰竭病人中的应用

目的比较经鼻盲探气管插管和气管切开在抢救呼吸衰竭病人的治疗效果。方法回顾性对比分析同期ICU住院病人采用经鼻盲探气管插管或气管切开建立人工气道后的病情转归,使用呼吸机后血气纠正时间,使用呼吸机时间,留置气管导管时间,平均住院时间及操作并发症。结果经鼻盲探气管插管组拔管率42.9%(9/21例),拔管成功率100%(9/9例);气管切开组拔管率60.7%(17/28例),拔管成功率76.5%(13/17例),两组间比较无显著性差异(P<0.05)。使用呼吸机后血气纠正时间无明显差别,但经鼻盲探气管插管组使用呼吸机时间,留置气管导管时间,平均住院时间均短于气管切开组(P<0.05)。气管切开组操作导致的并发症发生率46.4%(13/28例),而经鼻盲探气管插管组操作导致的并发症发生率23.8%(5/21例),明显少于前者(P<0.01)。结论经鼻盲探气管插管操作简便、实用,能减少并发症,缩短使用呼吸机时间,留置气管导管时间及住院时间,在抢救呼吸衰竭病人中较气管切开术有更好的临床应用价值。

Treatment of respiratory failure through blind nasotracheal intubation

Objective To compare the effects of blind nasotracheal intubation and tracheostomy in the treatment of respiratory failure. Methods A retrospective analysis was done on 49 cases with respiratory failure. Of all,21 cases were treated with blind nasotracheal intubation,28 cases were treated with tracheostomy, and the therapeutic effect, ventilation time, placing-tube time, time stay in ICU, blood gas improvement time and operative complications were observed in two groups. Results There were similar characteristics of blood gas improvement time and taking-tube time between two groups, but blind nasotracheal intubation had a short time of placing-tube, ventilation and stay in ICU compared with tracheotomy, also with few complications. Conclusions Blind nasotracheal intubation has an advantage over tracheotomy in patient with respiratory failure for it has convenient operation, few complications, shorter placing-tube time,ventilation time and time stay in ICU.