逆行气管插管在高位颈髓损伤并呼吸衰竭患者中的临床应用  

Clinical application of retrograde tracheal intubation in the high-level spinal cord injury combined with respiratory failure

作　　者：刘晓峰[1] 许庆林[1] 朱宏泉[1] 胡滢[1] 

机构地区：[1]赣南医学院第一附属医院重症医学科,赣州341000

出　　处：《中国当代医药》2014年第33期168-170,共3页China Modern Medicine

摘　　要：目的评价逆行气管插管在高位颈髓损伤并呼吸衰竭患者中的临床应用效果。方法选取2010年8月~2013年7月本科收治的42例高位颈髓损伤并呼吸衰竭患者,随机分为对照组（20例）和治疗组（22例）,对照组行经鼻纤维支气管镜引导气管插管,治疗组行逆行气管插管,观察两组患者首次气管插管成功率、插管时间、插管时出血率、插管后呼吸机相关性肺炎发生率、插管后气胸发生率、插管后脱离呼吸机成功率及成功脱机患者的机械通气时间。结果对照组首次气管插管成功率为95.0%,治疗组为95.5%,差异无统计学意义（P=0.732）;对照组插管时间为（5.13±1.84）min,治疗组为（3.97±1.09）min,差异有统计学意义（t=2.503,P=0.016）;对照组插管时出血率为10.0%,治疗组为13.6%,差异无统计学意义（P=0.547）;对照组插管后呼吸机相关性肺炎发生率为5.0%,治疗组为9.1%,差异无统计学意义（P=0.537）;对照组插管后气胸发生率为5.0%,治疗组未发生气胸,差异无统计学意义（P=0.476）;对照组插管后脱离呼吸机成功率为80.0%,治疗组为81.8%,差异无统计学意义（P=0.594）;对照组成功脱机患者的机械通气时间为（103.9±34.5）h,治疗组为（100.0±37.9）h,差异无统计学意义（t=0.347,P=0.765）。结论逆行气管插管在高位颈髓损伤并呼吸衰竭患者中插管成功率高,插管时间上有一定优势,可广泛应用于临床。Objective To evaluate the application of retrograde tracheal intubation in the high-level spinal cord injury patients with respiratory failure. Methods 42 patients with high-level spinal cord injury combined with respiratory failure treated in our hospital from August 2008 to July 2013 were selected,and were randomly divided into treatment group（22 patients） and control group（20 patients）.Nasal trachea cannula guided by bronchoscope was given to the control group,while retrograde tracheal intubation was taken to the treatment group.The success rate of intubation at first time,intubation time,incidence of bleeding and the incidence of ventilator-associated pneumonia,the incidence of pneumothorax after intubation,the success rate off ventilator after intubation and the duration of mechanical ventilation in patients successfully offline of the two groups were compared. Results The success rate of intubation at first time in the control group was 95.0%,while the treatment group was 95.5%,the difference was not significant（P=0.732）.The intubation time in the control group was（5.13±1.84） min,while the treatment group was（3.97±1.09） min,the difference was significant（t=2.503,P=0.016）.The incidence of bleeding in the control group was 10.0%,while the treatment group was13.6%,the difference was not significant（P =0.547）.The incidence of ventilator-associated pneumonia in the control group was 5.0%,while the treatment group was 9.1%,the difference was not significant（P =0.537）.The incidence of pneumothorax after intubation in the control group was 5.0%,while the treatment group did not occur,the difference was not significant（P=0.476）.The success rate off ventilator after intubation in the control control group was 80.0%,while the treatment group was 81.8%,the difference was not significant（P=0.594）.The average duration of mechanical ventilation in patients successfully offline in the control group was（103.9±34.5） hours,while the treatment group was（100.0±37.9） hours,the

关 键 词：高位颈髓损伤 呼吸衰竭 逆行气管插管 

分 类 号：R653[医药卫生—外科学]