摘要:目的：探討纖支鏡經(jīng)口引導(dǎo)氣管插管在慢阻肺合并重度呼吸衰竭救治中的臨床應(yīng)用價(jià)值。方法：237例慢阻肺合并重度呼吸衰竭患者,隨機(jī)分為纖支鏡經(jīng)口引導(dǎo)氣管插管組(纖支鏡組)125例和喉鏡經(jīng)口引導(dǎo)氣管插管組(喉鏡組)112例,分別在纖支鏡和喉鏡引導(dǎo)下按常規(guī)進(jìn)行氣管插管術(shù)。結(jié)果：纖支鏡組和喉鏡組一次獲得插管成功率分別為984%和920%(P＜005),平均插管時(shí)間分別為（613±391） min 和（926±415） min(P＜005)。纖支鏡組有5例患者出現(xiàn)咽喉部少量出血,并發(fā)癥發(fā)生率為4
0%;喉鏡組共有12例發(fā)生并發(fā)癥,并發(fā)癥發(fā)生率為107%(P＜005),其中齒、舌、咽或喉部損傷6例,反射性嘔吐致誤吸2例,單側(cè)肺通氣1例,插入食管2例,心跳呼吸驟停1例。結(jié)論：纖支鏡經(jīng)口引導(dǎo)氣管插管在慢阻肺合并重度呼吸衰竭救治中是一種簡(jiǎn)便快速、成功率高
和并發(fā)癥少的有效方法,值得臨床推廣應(yīng)用。
Abstract: Objective: To evaluate the efficacy of endotracheal intubation under fiberoptic bronchoscope through mouth in severe respiratory failure. Methods:Two hundreds and thirtyseven cases of severe respiratory failure were divided into two groups at random (fiberoptic bronchoscope group and laryngoscope group), 125 cases were intubated through mouth under fiberoptic bronchoscope, the others were intubated through mouth by laryngoscope. Results: The successful rates of endotracheal intubation were 98.4% and 92.0% in two groups respectively (P ＜005), the mean intubation time
were (613±391) min and (926±415) min respectively ( P ＜ 005), 4 cas
es in fiberoptic bronchoscope group appeared a little blood in throat, the complication rate was 32% 12 cases in the laryngoscope group had complications, the complication rate was 107%( P＜ 005). Among it, 6 cases had the inj
ury of tooth, tongue, gullet and larynx.The cases of reflexvomiting were 2,
pulmonary ventilation by single lung were 1, intubation in esophagus were 2, car
diopulmonary arrest were 1.Conclusions:Endotracheal intubation under fiberoptic bronchoscope through mouth was accurate, the fewer complications and effective for patients, and could be used widely in clinical applications.

引用本文： 何正光,邱容,肖昌武. 纖支鏡經(jīng)口引導(dǎo)氣管插管在慢阻肺合并重度呼吸衰竭救治中的臨床應(yīng)用探討. 華西醫(yī)學(xué), 2009, 24(12): 3117-3119. doi: 復(fù)制