支气管肺泡灌洗在呼吸科急重症抢救中的价值

The value of BAL in the emergenly treatment of serious and emergant respiratory disease

目的 :探讨支气管肺泡灌洗术 (BAL )在呼吸科急重症抢救中的成败关键及其价值。方法 :采用日本 OL YMPUS BF10纤支镜 ,按常规检查方法将镜顶部楔入相关叶段支气管开口 ,吸净分泌物或血液 ,酌情适量灌入灌洗液 ,反复数次 ,术后 2 4～ 4 8h复查胸片 ,必要时 3～ 6 d重复一次。结果 :14例 COPD慢性呼衰加重期患者中 ,7例有效 ,7例死亡 ;15例急性呼衰患者中 ,13例治愈 ,2例死亡。结论 :支气管肺泡灌洗在呼吸科急重症抢救中 ,安全、可靠、见效快 。

Objective:To investigate the clinical value of bronchoal veolar lavage(BAL) in the energency treatment of seriousand emergent respiratory diseases and the crucial factors influencing the result of the performance Methods: BAL was performed under OLYMPUSE BF 10 fibrobronchoscopy. The top of fibrobronchoscopy was wedged in the peristome of the target segmental bronchus following regular operation approach. Then secrehions and blood were aspirated conpletely. Quantum satis of lavage fluid was irrigated into the target bronchus. The above performences were done 24～48hrs after the operation and repeated in 3～6days when it was needed. Results: In 14cases of aggravating chronic respiratory failure, BAL was effective in 7 cases and the other 7 cases were dead. In 15 cases of acute respiratory failure, 13 cases were cured after BAL and 2 in 7 cases and theo ther 7 cases were dead. The 15 cases of acute respiratory failrue, 13 cases were cured after BAL and 2 cases were dead.Conclusions:BAL is a safe, reliable and rapidly efficacious approach in the emergency treatment of serious and energent respiratory disease, especially in the first aid of acute respiratory failure.