探讨纤维支气管镜治疗严重连枷胸肺不张的有效性和安全性

Study of fiberoptic bronchoscopy is effective and safe in treating severe flail chest pulmonary atelectasis

目的对纤维支气管镜治疗严重连枷胸肺不张的有效性和安全性展开分析与探讨。方法回顾性分析20例严重连枷胸肺不张患者资料,所选患者均采用在机械辅助通气下纤维支气管镜作为临床治疗方法。结果在治疗效果上,患者治疗前的动脉血p H值为(7.27±0.06)、动脉血氧分压为(56.25±0.09)mm Hg、动脉血二氧化碳分压为(55.54±0.74)mm Hg、血氧饱和度为(0.83±0.01),心率为(116±11)bpm,治疗后的动脉血p H值为(7.38±0.03)、动脉血氧分压为(84.42±0.34)mm Hg、动脉血二氧化碳分压为(44.37±0.79)mm Hg、血氧饱和度为(0.96±0.01),心率为(90±7)bpm,患者治疗后的各项指标相较于治疗前都出现了明显改善,组间数据比较差异有统计学意义(P<0.05);在安全性上,有13例患者发生窦性心动过速,有4例出现过较明显的低氧血症(SPO2<68%),但均很快恢复,未出现严重并发症与死亡现象。结论纤维支气管镜治疗严重连枷胸肺不张具有有效性和安全性。

Objective The fiber bronchoscope in the treatment of severe flail chest atelectasis efficacy and safety on analysis and discussion.Methods Retrospective analysis20cases of patients with severe flail chest atelectasis,selected patients with fiber bronchoscope under mechanical assisted ventilation as clinical treatment.Results The curative effect of the patients before treatment,arterial blood pH(7.27±0.06),PaO2was(56.25±0.09)mmHg,PaCO2was(55.54±0.74)mmHg,oxygen saturation(0.83±0.01),heart rate(116±11)BPM,after treatment the arterial blood pH is(7.38±0.03),PaO2was(84.42±0.34)mmHg,PaCO2was(44.37±0.79)mmHg,oxygen saturation(0.96±0.01),and heart rate(90±7)BPM,the indexes after treatment were compared with before treatment were significantly improved,the differences were significant data between groups was statistically significant(P<0.05);in security,13cases of sinus tachycardia,4patients had hypoxemia obviously(SPO2<68%),but were soon return no.Severe complications and death.Conclusion For patients with severe flail chest atelectasis by mechanical assisted ventilation without interruption downward fiber bronchoscope treatment,reduce the clinical complications,improve the clinical curative effect.