重症监护治疗病房内气管插管180例临床分析

    Tracheal intubation in intensive care unit:a report of 180 cases

    • 摘要: 目的:分析重症监护治疗病房(ICU)内患者气管插管的特点及并发症发生率,探讨适宜的插管时机和策略。方法:ICU内180例气管插管患者中,医生预先评估有插管指征并作插管准备者98例为计划插管组,因病情突变或意外拔管作紧急气管插管者82例为紧急插管组,总结2组插管成功次数、时间及插管并发症。结果:180例患者中1次插管成功率低(58.9%),插管并发症中低血氧者83例(46.1%)。计划插管组低血氧发生率较紧急插管组显著减少(P0.01),2次插管成功率高于紧急插管组(P0.01)。结论:医生预先评估ICU患者的病情进展趋势主动插管可提高紧急插管成功率,减少插管时间及并发症。

       

      Abstract: Objective:To analyze the clinical features and complications of tracheal intubation in intensive care unit(ICU),and to explore the suitable time and strategy.Methods:One hundred and eighty patients receiving tracheal intubation in ICU were divided into the schedule group and the emergency group.The schedule group(98 cases) had indications for intubation and were fully prepared,while the emergency group(82 cases) underwent intubations without full preparation due to rapid progression of the disease and accidental extubation.The time of intubation,the number of intubation attempts and the related complications of the two groups were recorded.Results:The success rate of intubation was 58.9% on the first attempt in all the 180 cases.The main complication during and after induction was hypoxemia(46.1%).The schedule group were superior to the emergency group,success rate of the second attempt and hypoxemia incidence(P〈0.01).Conclusions:The tracheal intubation in ICU is difficult and tends to have more complications.Early recognition of patients with indications and sufficient preparation are critical to successful bedside intubation.

       

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