老年Ⅱ型呼吸衰竭呼吸机治疗两种插管方式比较  

Comparative study of elderly patients with type Ⅱ respiratory failure treated with the orotracheal and nasotracheal intubation mechanical ventilation

作　　者：聂舟山[1] 舒六一[1] 温居一[1] 冯华松[1] 丁新民[1] 赖莉芬[1] 张新红[1] 孟激光[1] 李泳群[1] 李毅[1] 

机构地区：[1]海军总医院呼吸内科,北京100048

出　　处：《武警医学》2012年第3期214-216,共3页Medical Journal of the Chinese People's Armed Police Force

基　　金：国家"十一五"计划攻关项目(编号08G040)

摘　　要：目的观察、比较经口与经鼻气管插管的优缺点。方法使用经口与经鼻气管插管呼吸机治疗老年Ⅱ型呼吸衰竭患者1332例,697例应用纤维支气管镜引导下经鼻气管插管;635例行经口气管插管。给予间歇正压辅助呼吸,动态观察血气分析。结果两组抢救3～7 d疗效满意;经鼻气管插管较经口气管插管有顺应性好、并发症少、能耐受较长期治疗等优点。结论对于较长时间内需要有创呼吸机辅助治疗的慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)老年Ⅱ型呼吸衰竭患者应以经鼻气管插管为首选治疗方法;紧急情况下仍应经口插管。Objective To study the advantages and disadvantages of orotracheal and nasotracheal intubation mechanical ventilation used to treat 1332 elderly patients with type Ⅱrespiratory failure.Methods 697 patients underwent a fiberoptic bronchoscope-guided intubation through the nose while 635 patients were treated with orotracheal intubation.Then,intermittent positive pressure ventilation（IPPV） was given.Dynamic blood gas analysis was observed.Results The therapeutical effect in the two groups was satisfactory after three to seven days of rescue.Good compliance,few complications,and tolerance of long-term treatment were observed in the nasotracheal intubation group,compared with the orotracheal intubation group.Conclusion Nasotracheal intubation is a preferable treatment for elderly COPD patients with type Ⅱrespiratory failure who require a long-term invasive mechanical ventilation treatment while oral intubation is suited to emergency.

关 键 词：老年 Ⅱ型呼吸衰竭 经口气管插管 经鼻气管插管 呼吸机治疗 

分 类 号：R563.8[医药卫生—呼吸系统]