纤支镜代替胸腔镜诊治的安全性、实用性研究

Investigation of Security and Practicability in Thoracoscope Using Fiberoptic Bronchoscope

目的 :评价纤支镜代替硬质胸腔镜作胸腔内诊治的安全性和实用性。方法 :对 2 5例胸腔积液和 2 2例自发性气胸患者纤支镜代替硬质胸腔镜行胸腔内诊治 ,同时监测肺阻抗血流图、血气、生命体征等。结果 :胸腔积液患者检查时平均肺动脉压 (MPAP)、心率、呼吸频率明显高于术前及术后 (P <0 .0 5 ) ;所有患者术中及术后未见严重并发症 ;胸腔积液组中 ,2 2例获病理诊断 ,气胸组中 11例成功进行镜下胸膜破裂口或胸膜下肺大疱修补治疗。结论 :对于术前肺功能良好的患者 ,该项检查不致引起严重的呼吸和循环系统严重并发症。该项诊疗技术具有操作方便、视野广及诊疗效果好等优点 。

Objective: In order to evaluate the security and practicability of thoracoscope examination and treatment using Fiberoptic Bronchoscope. Methods: 25 patients of pleural effusion and 22 patients of spontaneous pneumothorax were performed thoracoscope with fibrobronchoscope, while Pulmonary impedance plethysmogram monitoring.were given and changes of Vital signs, indexes of ECG and blood gas analysis were also recorded. Results: The mean Pulmonary Arterial Pressure (MPAP) and heart rate of pleural effusion patients were significantly higher in the course of operation than in per and post operation (P<0.05); No serious side effects occurred in all patients. 22 patients of pleural effusion were given corrective pathologic diagnosis, and treatments with Fiberoptic Bronchoscope instead of thoracoscope were successed in 11 patients with spontaneous pneumothorax. Conclusion: the operation did not increase incidents of critical side effects in patients which cardiac and pulmonary function are normal before operation. It is suggested the technique of thoracoscope using Fiberoptic Bronchoscope has obvious advantages in examination and treatment of pleura and lung diseases due to its convenience, broad field of observation and low incidents of critical side effects.