吸痰管导引经鼻气管插管在ICU中的应用

目的探讨吸痰管导引经鼻气管插管在ICU危重症患者中的应用价值。方法选择2009年5月-2011年5月淮北矿工总医院ICU收治的危重症呼吸衰竭患者78例,采用吸痰管导引经鼻气管插管建立人工气道行机械通气,观察插管成功率及插管并发症。结果本组患者70例一次插管成功,成功率90%,插管时间20～60 s,4例患者在气管插管钳帮助下插管成功,3例患者改经口气管插管,1例患者经口气管插管失败,改气管切开。3例患者出现鼻腔少量出血,很快自行停止,无喉痉挛、严重心律失常、支气管痉挛、大咯血、心跳骤停等并发症发生。结论采用吸痰管导引经鼻气管插管能快速、简便、安全地建立人工气道,有较高的插管成功率,并发症少,值得在临床推广应用。

Clinical Application of Suction Catheter-Guided Nasotracheal Intubation in ICU

Objective To study the clinical application of suction catheter-guided nasotracheal intubation in critical illness patients in ICU.Methods Seventy eight critical patients with respiratory failure underwent mechanical ventilation in which the artificial airway was established by suction catheter-guided nasotracheal intubation in ICU from may 2009 to may 2011.The successful rate of intubation and complications were observed.Results The successful rate of first attempt was 90%(70/78),intubation time was 20-60 seconds.4 patients needed the tracheal intubation wrench,3 patients switch to orotracheal intubation,1 patients switch to tracheotomy.All of the patients did not appear laryngospasm,serious arrhythmia,bronchospasm,massive hemoptysis or cardiac arrest;3 patients were with a few nasal bleeding.Conclusion By using suction catheter-guided nasotracheal intubation we can create a artificial airway quickly,and the method is,with a high successful rate and few complications,simple and safe.