床旁支气管镜在ICU机械通气患者中的应用体会

Experience of application of bedside bronchoscope in mechanical ventilation for ICU patients

目的探讨床旁支气管镜治疗在ICU机械通气患者中的应用。方法对ICU病房52例机械通气患者进行早期床旁支气管镜检查,给予镜下清理气道分泌物,止血,灌洗或局部抗生素治疗。对血气分析指标的变化以及气道峰压、潮气量及胸片等进行前后对照。结果患者总呼吸频率、气道峰压、潮气量较治疗前均明显好转(P<0.05),治疗后胸片显示48例感染灶改善,治疗前后血气分析指标和患者生命体征无明显改变。结论在ICU机械通气的患者中早期行床旁支气管镜治疗,可以明显改善患者的通气功能,对感染控制起辅助作用。

Objective To explore the application of bedside bronchoscope in patients treated with mechanical ventilation in ICU de- partment. Methods The bedside bronehoseope was performed in 52 patients treated with mechanical ventilation in ICU department, and then the patients were given lavage or topical antibiotics after cleaning up the debridement airway secretions and stopping the bleed- ing. The blood gas analysis, changes of peak airway pressure, tidal volume and chest X-ray were analyzed and compared before and after treatment. Results The total respiratory rate, peak airway pressure, tidal volume of patients significantly became better after mechan- ical ventilation （P 〈 O. 05 ） ,the chest X-rays of 48 patients were improved, and the blood gas analysis and vital signs in patients showed no significant changes before and after treatment. Conclusion Bedside bronchoscope can significantly improve the patient＇ s ventila- tor function and play a supporting role in the infection control of ICU patients treated with mechanical ventilation in early treatment.