正压式头罩的三级防护下新型冠状病毒肺炎经支气管镜引导气管插管12例临床分析  

Analysis of bronchoscope-guided tracheal intubation in 12 cases with coronavirus disease 2019 under the personal protective equipment with positive pressure protective hood

作　　者：蔡水江 吴璐璐[2] 陈迪非 李幼霞 刘勇进 范银强 杜淑华 黄煌[1] 刘妮[2] 程璘令[2] 邓西龙[1] 李时悦[2] Cai Shuijiang;Wu Lulu;Chen Difei;Li Youxia;Liu Yongjin;Fan Yinqiang;Du Shuhua;Huang Huang;Liu Ni;Cheng Linling;Deng Xilong;Li Shiyue(Intensive Care Unit,Guangzhou 8th People′s Hospital,Guangzhou 440111,China;Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Guangzhou Medical University,National Clinical Research Center for Respiratory,Guangzhou Institute of Respiratory Disease,Guangzhou 510120,China)

机构地区：[1]广州市第八人民医院重症医学科,440111 [2]广州医科大学附属第一医院呼吸与危重症医学科,广州呼吸健康研究院,国家临床医学研究中心,510120

出　　处：《中华结核和呼吸杂志》2020年第4期332-334,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：气管插管是呼吸道传染病独立的感染危险因素。回顾性分析正压过滤头罩、三级防护下,12例新型冠状病毒肺炎患者气管插管的麻醉、插管方法、并发症,以及9名参加操作医务人员之后14 d的体温和核酸检测结果。在咪达唑仑+丙泊酚+吗啡/芬太尼镇静镇痛、麻醉下,12例患者均顺利、成功地在支气管镜引导下完成气管插管,未出现严重并发症。9名医务人员均未出现发热,咽拭子核酸检测阴性。新型冠状病毒肺炎患者气管插管时,医务人员在正压过滤头罩、三级防护下,没有出现感染,佩戴防护用品可安全、顺利完成操作。Endotracheal intubation is an independent risk factor for respiratory infectious diseases.We conducted a retrospective study in 12 cases with COVID-19 who underwent endotracheal intubation at ICU of the Guangzhou eighth hospital from January 20 to February 10,2020.The intubation procedure,anesthetic regimen,and complication were collected and analyzed.The 9 healthcare workers who involved in intubation received virus nucleic acid test and 14 days temperature monitoring.All 12 patients were successfully intubated under the guidance of bronchoscope,without any complications.Midazolam,Propofol and Morphine or fentanyl were used for sedation and analgesia,avoiding patients cough and agitated during the procedure.The 9 healthcare workers were protected under the Personal Protective Equipment(PPE)with positive pressure protective hood.The detection of oropharyngeal swab virus nucleic acid were negative in all 9 healthcare workers,none of them had fever or any respiratory symptoms.The PPE with positive pressure protective hood should be needed to perform bronchoscope-guided endotracheal intubation in patients with COVID-19,it could strengthen to protect healthcare workers from virus exposure.

关 键 词：气管插管 支气管镜引导下 正压头罩 新型冠状病毒肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]