慢性肺部感染性疾病支气管肺泡灌洗时内导管的应用

THE USE OF INTERNAL TUBE FOR THOSE PATIENTS WITH CHRONIC INFECTIOUS PULMONARY DISEASES DURING BRONCHOALVEOLAR LAVAGE (BAL)

提高纤维支气管镜检查的安全性及病人对操作的耐受性和支气管肺泡灌洗的治疗效果。方法 :选择 1995年以来的患慢性肺部感染病人 2 6例 ,观察应用内导管与高频喷射呼吸机相联时的氧合及麻醉效果 ,灌洗液回收率、灌洗治疗效果 ,并与鼻导管吸氧 ,环甲膜穿刺麻醉和未经内导管的灌洗对照。结果 :喷射给氧时从声带到段支气管血氧饱和度均高于鼻导管吸氧组 ,且越近远端饱和度升幅越大 ,喷麻组利多卡因平均用量为 (4 .8± 1.47)ml,环甲膜穿刺组平均用量 (15 .15± 3 .49)ml(P <0 .0 0 1) ,喷麻组咳嗽次数平均 2 .6次 ,而环甲膜穿刺组平均 4.41次 (P <0 .0 0 1)。经内导管的BALF回收率为 44 .2 6 % ,而未经内导管的BALF回收率为 33 .8% (P <0 .0 0 1)。结论 :经内导管的喷麻、给氧麻醉效果好 ,可避免操作中的低氧血症 ,明显提高血氧饱和度 ,操作安全 ,病人耐受性好 ,经内导管的BALF回收率提高 ,灌洗治疗效果好。

Objective: In order to increase the security and endurance or improve the effects of treatment for those patients with chronic infectious pulmonary diseases during BAL. Methods: We have studied 26 cases by using internal tube which connected to High Frequency Ventilation. The internal tube can eject oxygen and Lidocain (ejective oxygenation and ejective anaesthesis) into bronchial. We also performed BAL by means of it. Results: Compared with regular group ejective oxygenation increased Oxygen Saturation significantly: Ejective anaesthesis induced the amounts of Lidocain consumption and caused a less cough significantly. Internal tube increased recovery of BAL and improved the effects for those patients with chronic infectious pulmonary diseases. Conclusions: These methods are safety, endurable and effective.