摘要
目的评价纤维支气管镜(纤支镜)在慢性阻塞性肺疾病(COPD)并Ⅱ型危重呼吸衰竭患者救治中的作用。方法24例COPD并Ⅱ型危重呼吸衰竭患者采用纤支镜引导经鼻气管插管,实施机械通气。同时根据病情需要进行纤支镜吸痰冲洗术。结果纤支镜引导经鼻气管插管时间约2～3min,操作顺利,患者无明显不适,未发生气管插管相关并发症。经纤支镜行气管支气管吸痰冲洗后1h、4h,患者气道吸气峰压明显下降,动脉血气显著改善。结论熟练使用纤支镜经鼻气管插管可很快建立人工气道,吸除气管支气管内潴留的痰液。纤支镜用于COPD并危重呼吸衰竭患者的气道吸痰冲洗治疗能促进痰液引流,降低气道吸气峰压,改善肺泡通气。
Objective To evaluate the effect of fiberbronchoscope in treatment of patients with chronic obstructive pulmonary disease(COPD)induced severe type Ⅱ respiratory failure(RF).Methods Twenty four patients with COPD and severe RF received nasotracheal intubation introduced by fiberbronchoscope and mechanical ventilation,meanwhile carried out aspiration of sputum and douching in tracheobronchi by fiberbronchoscope.Results Nasotracheal intubation introduced with fiberbronchoscope was performed for 2 to 3 minutes and were successful in fulfilling operation in all patients.No complication associated with tracheal intubation.Arterial blood gases and airway peak inspiratory pressure of patients were significantly improved at one and four hours after aspiration of sputum and douching in tracheobronchi by fiberbronchoscope.Conclusions Artificial airway in patients with severe RF can be established immediately by nasotracheal intubation introduced with fiberbronchoscope.As need of condition,using fiberbronchoscope can aspirate out a great deal of sputum in tracheobronchi as soon as possible.So use of fiberbronchoscope in patients with severe RF may improve remove of sputum in airway,decrease airway peak inspiratory pressure,increase alveolar ventilation.
出处
《中国厂矿医学》
2004年第6期441-442,共2页
Chinese Medicine of Factory and Mine
