颈椎骨折脊髓损伤术后并发呼吸道梗阻使用纤维支气管镜吸痰灌洗的疗效观察

Curative effect of aspirating sputum and lavage by bronchofiberscopy in cervical fracture with spinal cord injury patients complicating obstruction of airway after operations

目的讨论颈椎骨折脊髓损伤术后并发呼吸道梗阻使用纤维支气管镜(纤支镜)吸痰灌洗的疗效。方法对16例(22例次)颈椎骨折脊髓损伤患者术后并发的呼吸道梗阻使用纤支镜吸痰和灌洗(BAL)治疗。结果所有患者于治疗后呼吸困难均明显改善,监测血氧饱和度(SaO2)及动脉血氧分压(PaO2)明显回升,术后根据痰菌培养药敏试验结果予以抗生素治疗,痰量明显减少,肺部感染控制满意。结论对颈椎骨折并脊髓损伤术后出现呼吸道梗阻的患者行纤支镜吸痰及灌洗(BAL)术,并指导抗生素的选择应用,有较明显的治疗效果,且安全可行,为解决颈椎骨折脊髓损伤患者术后并发的呼吸道问题提供了一个较好的治疗方法。

Objective To explore the clinical effect of aspirating sputum by bronchofiberscopy and bronchoalveolar lavage （BAL）in cervical fracture with spinal cord injury patients complicating obstruction of airway after operations. Methods Sixteen patients（22 cases times） of cervical fracture with spinal cord injury after operations were treated with bronchofiberscopy and bronchoalveolar [avage（BAL）. Results The dyspnea of all the cases after treatment were improved obviously,SaO2 and PaO2 increased. Antibiotics using was based on the sputum bacteria culture and durg sensitivity test and pulmonary infection was controlled well. Conclusion The treatment with bronchofiberscopy and bronchoalveolar lavage（BAL） is a valuable method to solve the sputum obstruction of airway in the patients with cervical fracture and spinal cord injury after operations.