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目的:研究纤维支气管镜下经鼻实施气管插管对妊娠晚期急性呼吸衰竭患者的临床效果。方法:将该院2010年1月~2013年1月收治的35例妊娠晚期急性呼吸衰竭患者作为研究对象,对其进行纤维支气管镜下经鼻实施气管插管治疗,观察治疗效果。结果:患者治疗后肺功能各项指标均有不同程度的改善,与治疗前相比差异有统计学意义(t=4.866 0,6.4549,17.528 6,4.296 0,3.182 2;P=0.000 0,0.000 0,0.000 0,0.001 5);患者治疗后血氧分压上升,二氧化碳分压显著下降,呼吸频率下降,逐渐平稳;上述指标与治疗前相比差异具有统计学意义(t=7.117 2,6.195 0,8.171 7;P=0.000 0);患者治疗后血清内白细胞介素-32、肿瘤坏死因子-α、单核细胞趋化蛋白-1等炎性因子水平明显下降,与治疗前相比差异有统计学意义(t=4.948 1,14.040 7,9.963 9;P=0.0000)。结论:气管插管后患者肺功能改善,二氧化碳分压明显下降,血氧分压增加,呼吸频率稳定,且血清炎性因子水平下降,具有一定的临床意义。
Objective: To study the clinical effect of endotracheal intubation under bronchofibroscopy on patients with acute respiratory failure in the third trimester of pregnancy. Methods: A total of 35 patients with acute third trimester of pregnancy with acute respiratory failure admitted to our hospital from January 2010 to January 2013 were enrolled in this study. The patients underwent endotracheal intubation under fiberoptic bronchoscopy, and the therapeutic effects were observed. Results: The indexes of pulmonary function in patients after treatment were improved to some extent, which were significantly different from those before treatment (t = 4.866 0,6.4549,17.528 6,4.296 0,3.182 2; P = 0.000 0,0.000 0,0.000 0,0.001 5). After treatment, the partial pressure of oxygen increased, the partial pressure of carbon dioxide decreased significantly, the respiratory rate decreased, and gradually became stable. The difference between the above indexes was statistically significant (t = 7.117 2, 0, 8.171 7; P = 0.000 0). Serum levels of interleukin-32, tumor necrosis factor-α, monocyte chemoattractant protein-1 and other inflammatory factors in patients after treatment were significantly lower than those before treatment Statistically significant (t = 4.948 1, 14.040 7, 9.963 9; P = 0.0000). Conclusion: After tracheal intubation, pulmonary function, carbon dioxide partial pressure decreased significantly, partial pressure of oxygen increased, respiratory rate was stable, and the level of serum inflammatory cytokines decreased, which has certain clinical significance.