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目的：探讨纤维支气管镜（纤支镜）引导经鼻气管插管对老年急性呼吸衰竭（呼衰）抢救的应用价值。方法：对３５例老年急性呼衰患者用纤支镜引导经鼻气管插管６３例次。患者取平卧位，选择较通畅的一侧鼻腔，先用１％地卡因行鼻腔及咽部粘膜喷雾麻醉３次，再用１％麻黄素液鼻腔粘膜喷雾以收缩鼻腔粘膜血管，减少或防止局部出血。纤支镜及导管内均涂以无菌硅油或液体石腊，将无菌气管导管套于纤支镜外。按纤支镜常规操作方法，由鼻腔插入气管，助手将气管导管沿纤支镜插入气管内，然后退出纤支镜。结果：纤支镜引导经鼻气管插管６３例次均获得成功。插管过程一般为２０秒～２分钟。结论：纤支镜引导经鼻气管插管抢救老年急性呼衰患者既安全，又迅速，值得推广。
Objective: To investigate the value of bronchoscopy (bronchofibroscopy) guided nasotracheal intubation for the treatment of senile acute respiratory failure (respiratory failure). Methods: Thirty-five elderly patients with acute respiratory failure underwent endotracheal intubation guided by fiberoptic bronchoscopy. Patient supine, select the more open side of the nasal cavity, first with 1% of the line of anesthesia nasal and pharyngeal mucosa spray anesthesia 3 times, and then 1% ephedrine nasal mucosal spray to shrink nasal mucosal blood vessels to reduce or Prevent local bleeding. Fiber bronchoscope and catheter are coated with sterile silicone oil or liquid paraffin, aseptic tracheal tube placed in bronchoscopy. According to the conventional operation of the bronchoscope, the nasal cavity is inserted into the trachea, and the assistant inserts the tracheal tube into the trachea along the bronchoscope, and then exits the bronchoscope. Results: Sixty-three cases of bronchofibroscopy guided nasotracheal intubation were successful. The intubation process is generally 20 seconds to 2 minutes. CONCLUSION: Fiberbronchial guided endotracheal intubation is safe and rapid for elderly patients with acute respiratory failure and is worth promoting.