床边便携式纤维支气管镜在临床中的应用研究

Application of bedside portable fibrobronchoscope technology in postoperative critical patients in department of thoracic surgery and in critical pantients of neurology department

目的探讨床边便携式纤维支气管镜在胸外科术后重症患者及神经科重症患者中的应用。方法分析我院2008年1月~2009年10月,床边便携式纤维支气管镜治疗胸外科术后重症患者及神经科重症患者的临床资料。结果床边便携式纤维支气管镜引导下经鼻气管插管25例,成功率100%。床边便携式纤维支气管镜气道吸痰30例,吸痰后患者胸部体征、动脉血氧分压、胸部影像学检查明显好转,纤支镜吸痰细菌培养阳性率80%。床边便携式纤维支气管镜下支气管肺泡灌洗18例,灌洗后患者动脉血氧分压明显升高,胸部CT示肺完全复张。结论床边便携式纤维支气管镜在胸外科术后重症患者及神经科重症患者的诊断治疗中,迅速、方便,疗效可靠,值得推广。

Objective To explore the role of bedside portable fibrobronchoscope technology in postoperative critical patients in department of thoracic surgery and in critical pantients of neurology department.MethodsThe clinical data of postoperative critical patients in department of thoracic surgery and critical patients in neurology department were analyzed between January 2008 to October 2009 which received urgent bedside portable fibrobronchoscope technology.Results25 cases received endotracheal intubation through the nose under the guidance of bedside portable fibrobronchoscope,the successful rate was 100%（25/25）.30 cases received suction under the guidance of portable fibrobronchoscope.After the procedure,the chest sign,arterial partial pressure of oxygen,the image of chest had a significant improvement.The positive rate of bacterial culture is 80%.18 cases with lobar or segmental atelectasis received bronchoalveolar lavage under the guidance of bedside portable fibrobronchoscope.After the bronchoalveolar lavage,all lungs fully re-expanded.ConclusionBedside portable fibrobronchoscope is a very importment approach in postoperative critical patients in department of thoracic surgery and in critical pantients of neurology department.It is a swift,convenient and effective rescue technique,and valued of popularization and application.