经鼻气管插管病人鼻窦炎发病的临床研究

目的探讨经鼻气管插管病人鼻窦炎的发生率及其与院内获得性肺炎的关系。方法40例气道开放的病人分为两组，A组（n=20）为经鼻气管插管组，B组（n=20）为经口气管插管或气管切开组，定时行鼻窦x线断层扫描及口咽部、鼻腔、下呼吸道分泌物培养，胸片检查，记录两组病人的鼻窦炎，院内获得性肺炎发病情况，细菌培养的结果，病人预后等数据。结果A组鼻窦炎发病率明显增高，但院内获得性肺炎，1周后APACHEⅢ评分，两周内死亡例数并无明显差异，鼻部分泌物和下呼吸道分泌物培养结果，病原体构成比并不一致。结论经鼻气管插管会使鼻窦炎的发生率增高，但并不一定会导致院内获得性肺炎的增加，两种疾病的常见致病微生物并不一致。

Investigation of nasosinusitis in nasotracheal intubation patients

Objective To investigate the velationship between the incidence rate of nasosinusitis in nasotracheal intubation patients and hospital acquired pneumonia. Methods 40 airway-opened paitents were randomly divided into two groups: Group A (n=20) with a nasotracheal intubation, and Group B (n=20) were orally intubated or received tracheostomy. All patients received nasosinusitis CT scan, pharynga 1 rhinal lower-airway bacterial culture and chest X-ray timely. Recorded were the measures of the amount of nasosinusitis, number of hospital-acquired pneumonia, bacterial culture results, and prognosis of paitents. Results Group A had a higher rate of nasosinusitis than Group B. The number of hospital-acquired pneumonia, APACHEIII grade after one week and death rate within two weeks were similar in the two groups. Pathogeny of nasal cavity was different from that of lower-airway. Conclusion Nasotracheal intubation increases chance of nasosinusitis, but not necessarily increases chance of hospital-acquired pneumonia. The commonly-seen pathogenies are different in the two types of the diseases.