纤支镜辅助鼻饲管置入在机械通气的慢阻肺病人中应用

张达成; 邵金莲; 崔海燕

doi:10.13418/j.issn.1001-165x.2018.04.022

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (4) : 453-456. DOI: 10.13418/j.issn.1001-165x.2018.04.022

临床研究

纤支镜辅助鼻饲管置入在机械通气的慢阻肺病人中应用

张达成¹，　邵金莲²，　崔海燕¹

作者信息 +

Application of fibreoptic bronchoscope-assisted nasogastric tube positioning in COPD patients with mechanical ventilation

ZHANG Da-cheng¹，SHAO Jin-lian²，CUI Hai-yan¹

Author information +

文章历史 +

摘要

目的　探讨机械通气的慢性阻塞性肺疾病（慢阻肺）病人经纤维支气管镜（纤支镜）辅助鼻饲管置入的临床应用效果。方法　选择我科2014年3月至2016年10月收治的机械通气的慢阻肺病人40 例，年龄平均（72.40±7.886）岁，随机分两组，实验组20例采用经纤支镜辅助鼻饲管置入，对照组20例采用常规方法鼻饲管置入。结果　实验组的一次置管成功例数、一次置管成功率、置管时间、并发症发生例数等指标均优于对照组（19 vs 9，95.0 vs 47.3，（8.37±1.34）vs（17.9±3.80），4 vs 12，P<0.05），但置管操作所需的医疗耗费明显高于对照组（（262±0）vs（12±0），P <0.05）。实验组置管前后心率、收缩压、舒张压、指脉氧饱和度、动脉血PaO2、动脉血PaCO2均无明显差异（（87.7±13.5）vs（89.9±13.8），（114.35±10.6）vs（115.1±9.2），（67.4±14.0）vs（68.7±9.9），（96.9±2.3）vs（97.2±2.2），（88.5±2.2）vs（82.0±19.2），（45.9±18.0）vs（38.4±2.6），P >0.05）。结论　机械通气的慢阻肺病人常规鼻饲管置入困难时，改用纤支镜辅助操作，简单迅速、安全可靠、损伤轻微、成功率高。

Abstract

Objective　To investigate the clinical effect of fiberoptic bronchoscope（FOB）-assisted nasogastric tube positioning in chronic obstructive pulmonary disease（COPD）patients with mechanical ventilation. Methods 40 mechanically ventilated COPD patients, enrolled from March 2014 to October 2016, were randomly divided into 20 patients（test group）with FOB-assisted nasogastric tube positioning and 20 patients（control group）with routine indwelling nasogastric tube. Results The indexes, including the first-attempt success cases, the first-attempt success rates, intubation time, number of complications, were significantly better in the test group as compared with the control group， which was opposite case for expenses (19 vs 9, 95.0 vs 47.3, (8.37±1.34) vs (17.9±3.80), 4 vs 12, (262±0) vs (12±0), P<0.05). There were no statistical differences in heart rate, systolic blood pressure, diastolic blood pressure, pulse oxygen saturation, arterial PaO2 and arterial PaCO2 between before and after indwelling nasogastric tube in the test group ((87.7±13.5) vs (89.9±13.8), (114.35±10.6) vs (115.1±9.2), (67.4±14.0) vs (68.7±9.9), (96.9±2.3) vs（97.2±2.2), (88.5±2.2) vs（82.0±19.2), (45.9±18.0) vs (38.4±2.6), P>0.05). Conclusion If the routine method is difficult in COPD patients with mechanical ventilation, it should be replaced by FOB-assisted operation because it is simple , quick, safe and reliable. Furthermore, slight injury can be incurred and high success rate can be achieved.

导出引用

张达成,邵金莲,崔海燕. 纤支镜辅助鼻饲管置入在机械通气的慢阻肺病人中应用[J]. 中国临床解剖学杂志. 2018, 36(4): 453-456 https://doi.org/10.13418/j.issn.1001-165x.2018.04.022

ZHANG Da-cheng，SHAO Jin-lian，CUI Hai-yan. Application of fibreoptic bronchoscope-assisted nasogastric tube positioning in COPD patients with mechanical ventilation[J]. Chinese Journal of Clinical Anatomy. 2018, 36(4): 453-456 https://doi.org/10.13418/j.issn.1001-165x.2018.04.022

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