纤维支气管镜诊治肺不张临床分析

Clinical analysis of diagnosis and treatment of pulmonary atelectasis by fiber bronchoscopy

目的:观察纤维支气管镜对肺不张诊治的临床疗效。方法:对60例肺不张患者应用纤维支气管镜进行检查及治疗,对所取得的标本进行分析,明确病因;对治疗后的患者的临床效果及血气分析、血氧饱和度进行观察记录分析。结果:60例肺不张患者中,肺癌患者28例,炎症患者13例,结核患者16例,其他病因3例,明确诊断率高达91.7%;60例患者中治愈患者13例,好转患者22例,无效患者25例,有效率为58.3%;其中25例无效患者中23例为肺癌患者,非肺癌患者治疗总有效率为93.75%。治疗前后相比较,治疗前血氧饱和度(92.3±2.1)%,治疗后(97.2±1.9)%,治疗前动脉氧分压(68.5±6.1)mmHg,治疗后(78.3±5.7)mmHg,治疗前二氧化碳分压为(51.3±4.2)mmHg,治疗后(38.7±3.9)mmHg,治疗前后相比较(P<0.05),差异有统计学意义。结论:纤维支气管镜在肺不张的诊断中诊断率显著,发挥着巨大的优势,在治疗中起到亦起到举足轻重的作用,尤其在非肺癌患者中,效果显著。

Objective： To observe the clinical diagnosis and curative value of applying the fiber bronchoscope on atelectasis.Methods： A total of 60 patients with pulmonary atelectasis undergoing fiber bronchoscope were involved in this study.The definite pathological diagnosis was based on specimens.The clinical outcomes,blood glass analysis results and blood oxygen saturation were recorded and analyzed.Results：Based on the pathological diagnosis,there were 28 patients with lung cancer,13 patients with inflammation,16 patients with tuberculosis and 3 patients with other pathogeny in total 60 patients.The definite diagnostic rate was up to 91.7%.In 60 patients,13 patients were cured,22 patients were improved and the other 25 patients had no response to treatment.The effective rate was 58.3%.Moreover,23 of 25 cases having no response to treatment were lung cancer.Thus,the effective rate of non-lung cancer was 93.75%.Significant differences of blood oxygen saturation,partial pressure of O2 and CO2 were observed before and after treatment （P〈0.05）.Conclusion： Fiber bronchoscopy has high diagnostic and curative value in atelectasis,especially in cases of non-lung cancer.