纤维支气管镜引导经鼻气管插管治疗慢性阻塞性肺疾病合并呼吸衰竭临床的研究.docVIP

纤维支气管镜引导经鼻气管插管治疗慢性阻塞性肺疾病合并呼吸衰竭临床的研究 　　摘 要 目的:探讨纤维支气管镜引导下经鼻气管插管抢救慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床价值。方法:对160例COPD合并呼吸衰竭患者采用纤维支气管镜引导下经鼻气管插管并进行机械通气,总结分析其临床资料。结果:纤维支气管镜引导下经鼻气管插管160例,均1次获得成功,插管时间0.5～4分钟,呼吸衰竭均明显改善,留管时间3～50天,平均14天,并发症少。结论:纤维支气管镜引导下经鼻气管插管治疗COPD合并呼吸衰竭抢救率成功率高,并发症轻,具有重要的临床应用价值。 　　关键词 纤维支气管镜 经鼻气管插管 慢性阻塞性肺疾病 呼吸衰竭 　　 　　doi:10.3969/j.issn.1007-614x.2010.22.057 　　Emergency management of nasal trachea cannula guided by bronchofibroscope to chronic obstructive pulm onary disease patients with respiratory failure 　　Wang Ying-Huo?1Cal shao-Xi?2 　　Department of interanal Medicine,the Peoples Hospital of zhaoqing Guangdong 526040,P.R.China;2.Department of Respiratory Disease,Nanfang Hospital of First P.L.A Medical University,Guangzhou,Guangdong 510515,P.R.China) 　　AbstractObjective:To investigate the value of nasal trachea cannula guided by bronchofthroscope in treating chronic obstructive pulmonary disease (COPD)patien with respiratory failur.Methods:160 COPD patiens with respiratory failur by endotracheal intubation through the nose guided by bronchofibroscope. Results:Intubation was successfully performed in all patients in single attempt,which took 0.5～4min,after mechanical ventilation for 30min,conspieuous improvement of respiratory failure was observed in all cases,the tubes were kept for 3 to 50 days.Conclusion:The artificial airway of nasal trachea cannula guided by bronchofthroscope can improve the achievement ratio of treating COPD patiens with respiratory failure witll slight complications.So the nasalachea cannula guided by bronchofibroscope is of great value in treating COPD patiens with respiratory failure. 　　Key Wordsbronchofibroscope;nasal trachea cannula;chronic obstructive pulmonary disease (COPD);respiratory failure? 　　慢性阻塞性肺疾病(COPD)合并呼吸衰竭是内科急重症,决定呼吸衰竭抢救成功与否的重要之一是迅速建立人工气道,进行机械通气治疗。 　　以往气管插管均在喉镜明视下进行,常出现一些并发症,轻者造成咽喉损伤、声带水肿、喉痉挛等,重者导致插管失败、严重缺氧等,甚至危及患者生命。纤维支气管镜引导下将气管导管送入气管内抢救COPD合并呼吸衰竭,其优越性逐步被认识。 　　2004年1月～2009年12月应用纤维支气管镜引导下经鼻气管插管抢救COPD合并呼吸衰竭患者160例,效果满