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目的观察、比较经口与经鼻气管插管的优缺点。方法使用经口与经鼻气管插管呼吸机治疗老年Ⅱ型呼吸衰竭患者1332例,697例应用纤维支气管镜引导下经鼻气管插管;635例行经口气管插管。给予间歇正压辅助呼吸,动态观察血气分析。结果两组抢救3～7 d疗效满意;经鼻气管插管较经口气管插管有顺应性好、并发症少、能耐受较长期治疗等优点。结论对于较长时间内需要有创呼吸机辅助治疗的慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)老年Ⅱ型呼吸衰竭患者应以经鼻气管插管为首选治疗方法;紧急情况下仍应经口插管。
Objective To observe and compare the advantages and disadvantages of oral and nasal tracheal intubation. Methods A total of 1332 elderly patients with type Ⅱ respiratory failure were treated with oral and nasal endotracheal intubation ventilator. 697 patients were treated with nasal endotracheal tube guided by fiberoptic bronchoscopy and 635 were treated with orotracheal intubation. Give intermittent positive pressure assisted breathing, dynamic observation of blood gas analysis. Results The two groups of rescue 3 ~ 7 d of satisfactory results; nasal endotracheal intubation than tracheal intubation has good compliance, fewer complications, can tolerate longer-term treatment and so on. Conclusion Nasopharyngeal intubation is the preferred treatment for chronic obstructive pulmonary diseases (COPD) in elderly patients with respiratory failure type Ⅱ for a long time. In emergency cases, Oral intubation.