CAJ | 학술논문

目的：探讨纤支镜引导下经鼻气管插管在颅脑外伤并发呼吸功能不全中的救治效果。方法：选择80例颅脑外伤合并呼吸功能不全患者作为研究对象，在积极治疗原发病的同时采用经纤维支气管镜引导经鼻气管插管实施机械通气，选择SIMV、A/C或PSV通气模式，根据病情调整呼吸机参数。结果：80例经鼻气管插管一次成功，成功率100％，平均(2.01±0.28)min；操作中无骨折、鼻窦炎等不良反应发生，留管平均(8.45±3.45)d；发生肺部继发感染5例，声音嘶哑10例，鼻出血9例，导管不全阻5例，意外拔管4例；72例存活出院，死亡8例，抢救成功率90.00％。结论：纤维支气管镜引导下经鼻气管插管是建立人工气道抢救颅脑外伤的重要措施之一，具有简便、迅速、创伤小、可反复应用及并发症少等优点。
목적：탐토섬지경인도하경비기관삽관재로뇌외상병발호흡공능불전중적구치효과。방법：선택80례로뇌외상합병호흡공능불전환자작위연구대상，재적겁치료원발병적동시채용경섬유지기관경인도경비기관삽관실시궤계통기，선택SIMV、A/C혹PSV통기모식，근거병정조정호흡궤삼수。결과：80례경비기관삽관일차성공，성공솔100％，평균(2.01±0.28)min；조작중무골절、비두염등불량반응발생，류관평균(8.45±3.45)d；발생폐부계발감염5례，성음시아10례，비출혈9례，도관불전조5례，의외발관4례；72례존활출원，사망8례，창구성공솔90.00％。결론：섬유지기관경인도하경비기관삽관시건립인공기도창구로뇌외상적중요조시지일，구유간편、신속、창상소、가반복응용급병발증소등우점。
Objective:Discussion the fiberoptic nasotracheal intubation under medical treatment in craniocerebral trauma complicated with respiratory insufficiency. Methods:Choose traumatic brain injury with respiratory insufficiency patients 80 cases as research object, In the active treatment of the original diseases by fiberoptic bronchoscopy guided nasotracheal intubation mechanical ventilation, Select SIMV, A/C or PSV ventilation mode, according to the condition of adjustment of mechanical ventilation parameters. Results:80 cases of nasal trachea cannula a success, the success rate was 100%, the average (2.01 ± 0.28) min;There is no fracture, operation of sinusitis and other adverse reactions, the remaining average (8.45±3.45) d;Incidence of pulmonary infection in 5 cases, 10 cases of hoarseness, 9 cases of nasal bleeding, 5 cases of ductal incomplete resistance, 4 cases of accidental extubation;72 patients were discharged, 8 patients died, the survival rate is 90%.Conclusions:Guided by fiber bronchoscope nasotracheal intubation is one of the important measures to establish artificial airway rescue craniocerebral trauma, Has the advantages of simple, rapid, less trauma, can be repeatedly used and less complications etc.