呼吸衰竭患者经鼻气管插管与气管切开疗效的比较观察

分析７６例呼吸衰竭患者经鼻气管插管与气管切开疗效的优缺点。其中Ｉ型呼衰３６例，Ⅱ型呼衰４０例。结果：Ｉ型呼衰经气管切开组，氧分压改善明显优于经鼻气管插管组。而由ＣＯＰＤ引起的Ⅱ型呼衰，气管插管和气管切开二者对ＰａＯ２和ＰａＣＯ２改善无明显差异。结论：Ⅱ型呼衰应以经鼻气管插管为首选治疗方法；对于分泌物多、严重二氧化碳潴留合并多器官功能衰竭的Ⅱ型呼衰患者，应及时气管切开。还介绍了预防气管感染及气管插管

Comparative Observations of Nasal Endotracheal Intubation and Tracheotomy in Patients with Respiratory Failure

76 cases with respiratory failure were selected, and comparative analysis of advantages and disadvantages of nasal endotracheal intubation and tracheotomy was carried out. Among 76 cases,36 cases were with type I and 40 cases with type II respiratory failure. The results showed that PaO_2 was more significantly improved in patients with type I respiratory failure after tracheotomy than that after nasal endotracheal intubation; and there was no significant difference in the improvement of PaO_2 and PaCO_2 for patients with type II respiratory failure between nasal endotracheal intubation and tracheotomy. It was suggested that nasal endotracheal intubation should be primarily selected for patients with type II respiratory failure, and tracheotomy should be made in time for patients of type II respiratory failure with more increased secretion, severe CO_2 retention and multiple Organ failure. It must be emphasized that early tracheotomy is necessary in the treatment of ARDS. The preventive precautions against airway infection and scar formation in patients using endotracheal tube were discussed in detail.