纤维支气管镜引导经鼻气管插管在呼吸监护病房的临床应用

The Clinical Application of the Bronchofibroscope Guiding the Nasal Tracheal Intubation in Respiratory Care Unit

目的探讨纤维支气管镜引导经鼻气管插管在呼吸监护病房的临床应用。方法选择呼吸监护病房的42例患者回顾性分析经纤维支气管镜引导经鼻气管插管连接机械通气治疗及取痰培养、吸痰、支气管冲洗、支气管肺泡灌洗、止血治疗等,总结分析临床资料。结果本组42例患者均进行纤维支气管镜引导经鼻气管插管,机械通气治疗,插管均一次性获得成功,平均插管时间<2min,机械通气患者成功撤机拔管,34例经过纤维支气管镜吸痰、支气管冲洗、取痰液送病原学培养加药敏,阳性率100%,支气管肺泡灌吸14例,3例咳血窒息经纤维支气管镜止血治疗出血停止,支气管冲洗,支气管肺泡灌吸,治疗前后血气及血氧饱和度复查,PaO2、SO2与治疗前后中相比有较明显增高,PaCO2明显下降,差异均有显著性(P<0.01)。结论纤维支气管镜引导经鼻气管插管在呼吸监护病房有较大的临床应用价值,操作简单、快速、安全。

Objective To evaluate the clinical application of the bronchofibroscope guiding the nasal tracheal intubation in respiratory care unit. Methods Takes the 87 selected patients with respiratory failure as example, to analyze the application and summarize the clinical data of the treatment of the bronehofibroscope guiding the nasal tracheal intubation connected to the mechanical ventilation, sputum incubating ＆ absrobing, bronchus washing, bronchus alveolus lavement and hemostatic treatment etc. Results All the selected patients received one-off treatment of intubation and mechanical ventilation successfully; The average of their intubation time no more than 2 minutes; Successful dismantlement after the patients receiving machanical ventilation; 34 patients after the treatment of bronchofibroscope sputum absorbing, bronchus washing and sputum incubating,the masculine rate is 100%; 14 patients received bronchus alveolus lavement; 3 patients with hemoptysis asphyxiation after receiving the bronchofibroscope hemostatie treatment stops hemorrhage, and they received bronchus washing and bronchus alveolus lavement, after all these treatment, the oxygen saturation of blood, PaO2, SO2 of the patients improves markedly, and the PaCO2 drops clearly, the difference is all obvious （P 〈 0.01 ）. Conclusion It is proved that the clinical application of the bronchofibroscope guiding the nasal tracheal intubation has great value,and it＇s easy to operate,can be performed rapidly,safely.