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目的:探讨床旁纤维支气管镜引导下经鼻气管插管与直接鼻气管插管在老年呼吸衰竭患者护理中的应用价值。方法选取2014年1月至2016年1月安徽医科大学第一附属医院收治的60例老年呼吸衰竭住院患者按随机数字表法分成观察组和对照组,每组各30例。观察组行床旁纤维支气管镜引导下经鼻气管插管,对照组行直接鼻气管插管。对比两组患者一次性插管成功率、插管时间、留置管时间、并发症发生率及插管前、后临床指标的变化情况。结果与对照组相比较,观察组一次性插管率明显更高(P<0.05),插管时间和留置管时间更短(P<0.05),并发症发生率明显更低(P<0.05);两组插管前临床指标[呼吸频率(RR)、二氧化碳分压(Pa CO2)、氧分压(Pa O2)]比较,差异均无统计学意义(P>0.05);插管后与对照组相比较,观察组RR、Pa CO2明显更低(P<0.05),而Pa O2则更高差异具有统计学意义(P<0.05)结论与直接鼻气管插管相比较,床旁纤维支气管镜引导下经鼻气管插管并发症更少,临床指标改善更为明显,是安全而有效的治疗方式。
Objective: To investigate the value of nasal endotracheal intubation and direct nasotracheal intubation under the guidance of bedside fiberoptic bronchoscope in the nursing of elderly patients with respiratory failure. Methods From January 2014 to January 2016, 60 elderly patients with respiratory failure admitted to the First Affiliated Hospital of Anhui Medical University were divided into observation group and control group according to random number table method, with 30 cases in each group. The observation group underwent bedside nasal tracheal intubation guided by fiberoptic bronchoscope and the control group received direct nasotracheal intubation. The success rate of one-time intubation, intubation time, catheterization time, the incidence of complications and changes of clinical indexes before and after intubation were compared between the two groups. Results Compared with the control group, the rate of one-time intubation was significantly higher in the observation group (P <0.05), the duration of intubation and catheterization was shorter (P <0.05), and the incidence of complications was significantly lower (P <0.05) ; There were no significant differences in clinical indexes (RR, PaCO 2, Pa O 2) before intubation between the two groups (P> 0.05) Compared with the direct nasotracheal tube intubation, the RR and PaCO2 in the observation group were significantly lower (P <0.05), while PaO2 was higher (P <0.05). Compared with direct nasotracheal intubation, Guided by the nasal endotracheal tube less complications, clinical indicators to improve more clearly, is a safe and effective treatment.