逆行气管插管与经鼻纤维支气管镜引导气管插管的临床比较  

Clinical Comparison of Retrograde Intubation and Bronchofibroscope-guided Nasal Trachea Cannula in Intensive Care Unit

作　　者：许庆林[1] 朱宏泉[1] 李葆华[1] 

机构地区：[1]江西省赣州市赣南医学院第一附属医院ICU,341000

出　　处：《中国全科医学》2011年第5期560-561,共2页Chinese General Practice

摘　　要：目的评估逆行气管插管与经鼻纤维支气管镜引导气管插管在气管插管困难的临床应用价值。方法 44例气管插管困难患者,包括用普通喉镜插管2~3次失败患者26例,术前评估为气管插管困难直接采用逆行气管插管或经鼻纤维支气管镜引导气管插管患者18例。选择23例患者行逆行气管插管,21例患者行经鼻纤维支气镜引导气管插管。结果逆行气管插管成功率100%,经鼻纤维支气管引导气管插管成功率95%,两组插管成功率比较,差异无统计学意义（χ2=1.12,P〉0.05）;逆行气管插管组平均用时（3.98±0.73）分,纤维支气管镜平均用时（5.19±0.82）分,两组比较差异有统计学意义（t=-5.079,P=0.00）;而两组出血率比较差异无统计学意义（2χ=2.39,P=0.71）。结论逆行气管插管取材更为方便,技术易于掌握,在控制插管时间上有一定优势。Objective To compare the clinical values of retrograde intubation（RI） and bronchofibroscope-guided nasal trachea cannula（BGNTC） in intensive care unit（ICU）.Methods Totally 44 patients with difficulties in trachea cannula were enrolled in this study.Of these patients,26 had experienced 2-3 times of conventional laryngoscpic intubation failure and 18 were pre-operatively assessed to be with difficulty in trachea cannula.Twenty three patients were intubated using retrograde traction technology（RI group）;21 patients were intubated under nasal trachea cannula guided by bronchofibroscope（BGNTC group）.Results The success rate was 100% in RI group and 95% in BGNTC group（χ2=1.12,P0.05）.The duration of intubation was（3.98±0.73） min in RI group and（5.19±0.82） min in BGNTC group（t=-5.079,P=0.00）.The incidence of bleeding showed no significant difference between these two group（χ2=2.39,P=0.71）.Conclusion Compared with BGNTC,RI has certain advantages including more convenient to obtain sample,simpler to perform,and easier to control intubation duration.

关 键 词：气管插管困难 逆行气管插管 经鼻纤维支气管镜引导气管插管 

分 类 号：R653.1[医药卫生—外科学]