纤维支气管镜在重型颅脑损伤患者救治中的应用

Application of fibrobronchoscopy in the management of severe brain injury

目的探讨纤维支气管镜在治疗重型颅脑损伤并肺部感染患者中的意义。方法对26例重型颅脑损伤并肺部感染患者行43次纤维支气管镜吸痰、支气管肺泡灌洗治疗。观察治疗前后患者呼吸系统症状、血氧饱和度（SaO2）、氧分压（PaO2）、二氧化碳分压（PaCO2）的变化情况，判断纤维支气管镜在重型颅脑损伤患者治疗中的作用。结果所有患者24h内体温下降，呼吸困难等症状减轻或消失；X线胸片示肺部浸润阴影缩小或不张的肺叶复张／或部分复张；血气分析结果示血PaO2、SaO2较治疗前明显提高，差异有统计学意义（P〈0．05）。结论纤维支气管镜在重型颅脑损伤并肺部感染患者救治中应用安全、有效，值得在临床推广应用。

Objective To evaluate the application of fibrobronchoscopy in the management of severe brain injury with concurrent pulmonary infection. Methods Forty-three procedures of fibrobronchoscopic sputum clearance or bronchoalvelar lavage were performed in 26 patients with severe brain injury and concurrent pulmonary infection. The effect of fibrobronchoscopic treatment was assessed by observing the changes in the respiratory symptoms, arterial oxygen saturation （SaO2） and partial pressure of oxygen （PaO2） in these patients. Results The symptoms of the respiratory system, SaO2, and PaO2 of the 26 patients were significantly improved after fibrobronchoscopic treatment, which caused no serious complications. Conclusion Fibrobronchoscopy can be safely and effectively used in patients with severe brain injury complicated by pulmonary infection.