纤维支气管镜在严重胸部创伤诊断及治疗中的价值.pdfVIP

.516. • JJ匈密R据司钞王· 纤维支气管镜在严重胸部创伤 诊断及治疗中的价值 刘朝普张连阳黄泉凯她元章 [摘哥哥} 目的 探讨纤维支气管镜(简称纤文镜)在严戴胸部创伤的珍断及拍疗中的价值。 方法 翩翩性分析我院 1999 年 1 月 -2007 年7 月应用纤支镜进行诊断放治疗的严撮胸部创伤患 者 114 例。总共应用纤交错检查、模搅治疗289 快。纤支镜进入途径:经鼻腔 181 次，气管插智32 快，口脏20 次，气管切口褒管56 次。术前、术中、术脂严密监护和监测 5a0 1是血气分析，同时给予 2 吸氧戒呼吸机支持。 结果 114 例经纤支镜检查明确诊断，对 102 例患者进行了耀恍治疗。全 部患者纷 1 ~4 次纤支镜检资及耀搅后 5a0 均明跟提高(P 0. 01) ，术后 2 h Pa02 改善明跟(P 2 0.05) 。先剧纤支铺检菇治疗导致死亡的患者。 结论 纤支镜在严重胸部创伤中有戴安的诊断 及治疗价筒，不但可及时明确支气管损伤的诊断，而且可以有效清除气道异物、分撼物、血及痰翩， 情疗阳靠性肺不张及阻赛性肺炎，明.Iæ改善呼吸功能、提高救治成功率。 [关键词} 胸部损伤; 气管镜检查; 支气管肺泡横洗 Role of fibrobronch栅copy in 创agn，ωis and trea伽lent of severe cbωt trauma UU C，阳。阳， ZHANG lian-yang , HUANG Xian-制， YAO Yuan-z，阳ng. Center of War Wound and Traunω， Research butÏlue of Surgery , Daping Hospi时， Third Milωry Medical Uníversity , Chongqír啄 4αlO42 ， Chína [ AbstractJ 0时则ve To explore the role of fibrobron伽copy in dia阴阳s and tre翩翩。f 仲 vere ch倒t lrauma. Methods A retrospective analysis was done on 114 patients wi由 severe chest trau- ma who WI刷di明lOsed and trω， .ted by fibrobronchosco阳 from Janu创y 1999 to July 2∞饥 We finished 289 times of fibrobroncho西copies including 181 time唱 through nasal cavity , 32 through tracheal , 52 through oral cavity 削d56 伽rough tracheostomy tube. 5a02 and arterial blood g捕 were monitored continu- ously before and after operation. and re自pirator support or oxygen wωadministered simultaneously. Re. sults Definite dia伊osis was achieved in all patients , of whom were 102 patients treated 呐th lavement. Sa02 w幽 si伊ificantly incre倡ed in all patien恼 after bronchial lavement (P 0.01) and Pa02 was 时gnífi. ωntly ameliorated two hours after bronchial lavement (P O. 05). ConcI田io皿 Fihrohronchoscopy t棚 identify di咽losis of h