内科电子胸腔镜检查监护和并发症防治

Monitoring and prevention and treatment of complications in medical electron-assisted thoracoscopic surgery

目的探讨内科电子胸腔镜检查对心电、血压、呼吸和血氧饱和度的影响以及并发症的防治。方法对250例行内科电子胸腔镜检查过程的监护和并发症进行回顾分析。结果内科电子胸腔镜检查前、中、后患者SPO2、HR、BP、R的变化差异无显著性(P>0.05),检查过程中于活检时,SPO2(92.7±3.4)%最低,HR(97.55±17.37)次/min、SBP(17.92±2.88)kPa、DBP(11.45±1.92)kPa、R(28.57±5.79)次/min最高,并发症主要有生命体征不稳定发生率为7.2%,疼痛为92.8%,胸膜反应为0.4%,发热13.2%,局限性皮下气肿4.8%,伤口寒性脓肿1.6%,250例行病理活检者均有活检部位少量出血,不需特殊处理,未见严重出血者。结论内科可弯曲胸腔镜检查是安全、可行的,并发症少,值得推广。

[Objective] To discuss the impact of medical electron-assisted thoracoscopic surgery on the ECG, blood pressure （BP）, respiration （R） and blood oxygen saturation （SPO2） and prevention and treatment of complications. [Method] Inspection process monitoring of 250 cases receiving medical electron-assisted thoracoscopic surgery and complications were retrospectively analyzed. [Results] The changes of patients＇ SPO2, HR, BP and R were not significant during medical electron-assisted thoracoscopy （P 〉0.05）, During the inspection process, SPO2 （92.7±3.4）% was minimium when biopsy was made, HR （97.55±17.37）/minute, SBP （17.92±2.88） kPa, DBP （11.45± 1.92） kPa and R [（28.57±5.79）/minute] were maximum, complications mainly included life sign instability （7.2%）, pain （92.8%）, pleural reaction （0.4%）, fever （13.2%）, hmited of subcutaneous emphysema （4.8%）, wound cold abscess （1.6%）. All the 250 cases had a small amount of bleeding in biopsy location, no serious bleeding appeared without special handhng,. [Conclusion] Medical flexible electron-assisted thoracoscopic surgery is safe and feasible with no serious compheations and should be promoted. A suitable patient needs to be chosen for the inspection.