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目的探讨纤维支气管镜引导下经口气管插管在急诊气管插管中的应用价值。方法 70例需气管插管的重症患者,按照气管插管方法的不同分为观察组和对照组,各35例。对照组患者采用常规经口气管插管,观察组患者采用纤维支气管镜引导下经口气管插管。比较两组患者气管插管时间、一次插管成功率及并发症发生率,监测插管期间的舒张压(DBP)、收缩压(SBP)和心率(HR)变化情况。结果观察组气管插管时间明显短于对照组,差异具有统计学意义(P<0.05);观察组一次插管成功率为97.14%,明显高于对照组的80.00%,差异具有统计学意义(P<0.05);观察组并发症总发生率为5.71%,明显低于对照组的31.43%,差异具有统计学意义(P<0.05)。气管插管后1 min,两组患者DBP、SBP和HR均较插管前明显升高,但观察组明显低于对照组,差异均具有统计学意义(P<0.05)。插管后3、5 min,观察组患者DBP、SBP和HR与插管前比较差异无统计学意义(P>0.05);但对照组仍明显高于插管前,差异均具有统计学意义(P<0.05)。结论纤维支气管镜引导下经口气管插管在急诊气管插管应用优于常规经口气管插管,能提高一次性插管成功率,降低并发症发生率,减轻插管导致的血液动力学应激反应,值得在急诊推广使用。
Objective To investigate the value of bronchoscope guided oral tracheal intubation in emergency tracheal intubation. Methods Seventy patients with severe tracheal intubation were divided into observation group and control group according to the method of tracheal intubation, 35 cases each. The control group of patients with conventional orotracheal intubation, observation group under the guidance of bronchoscopy bronchial intubation. Tracheal intubation time, primary intubation success rate and complication rate were compared between the two groups. DBP, SBP and HR were monitored during intubation. Results The tracheal intubation time in the observation group was significantly shorter than that in the control group (P <0.05). The success rate of primary intubation in the observation group was 97.14%, which was significantly higher than that in the control group (80.00%), the difference was statistically significant P <0.05). The overall incidence of complications in the observation group was 5.71%, which was significantly lower than that in the control group (31.43%). The difference was statistically significant (P <0.05). At 1 min after tracheal intubation, DBP, SBP and HR in both groups were significantly higher than before intubation, but the observation group was significantly lower than the control group, the difference was statistically significant (P <0.05). There was no significant difference in DBP, SBP and HR between before and after intubation in observation group (P> 0.05), but the control group was still significantly higher than that before intubation P <0.05). Conclusion Oral endotracheal intubation guided by fiberoptic bronchoscopy is superior to conventional orotracheal intubation in emergency tracheal intubation, which can improve the success rate of one-time intubation, reduce the incidence of complications and reduce the hemodynamic response to intubation Agitation, it is worth to promote the use of emergency.