纤维支气管镜诊疗所致严重并发症临床分析及防治方法探讨.docVIP

纤维支气管镜诊疗所致严重并发症临床分析及防治方法探讨 　　[摘要] 目的 探讨纤维支气管镜检查与治疗过程中发生的严重并发症及防治方法。 方法 回顾分析2011年1月～2016年4月我科纤维支气管镜检查与治疗的2753例患者的临床资料和发生的严重并发症及防治方法。 结果 2753例患者纤维支气管镜检查与治疗共发生严重并发症12例，其中死亡2例，严重低氧血症3例，继发肺部感染6例，支气管痉挛1例，严重并发症发生率4.36‰，死亡率0.73‰。 结论 纤维支气管镜检查与治疗可以出现严重并发症，随着纤维支气管镜介入治疗的广泛开展，严重并发症的发生率和死亡率有增加趋势。严格掌握适应证、检查前的充分准备是减少和预防严重并发症的有效方法。 　　[关键词] 纤维支气管镜；支气管镜；严重并发症；防治 　　[中图分类号] R768.1 [文献标识码] B [文章编号] 1673-9701（2016）19-0047-04 　　[Abstract] Objective To explore severe complications and prevention and treatment methods during the examination and treatment under fiber bronchoscope. Methods Clinical data of 2753 patients who were examined and treated under fiber bronchoscope in our department from January 2011 to April 2016， as well as severe complications induced by it and prevention and treatment methods were retrospectively analyzed. Results In the examination and treatment under fiber bronchoscope for 2753 patients， severe complications were seen in 12 patients， among whom 2 cases were deaths， 3 cases of severe hyoxemia， 6 cases of secondary pulmonary infections， and 1 case of bronchospasm. The incidence rate of severe complications was 4.36‰， and the mortality rate was 0.73‰. Conclusion Examination and treatment under fiber bronchoscope may induce severe complications. With the wide application of interventional therapy of fiber bronchoscope， the incidence rate and mortality rate of severe complications have been increasing. Strict mastering of indications and thorough preparation before examination are effective methods to reduce and prevent severe complications. 　　[Key words] Fiber bronchoscope； Bronchoscope； Severe complications； Prevention and treatment 　　纤维支气管镜自1966年首次出现在国际胸部疾病大会上，就引起了世人的瞩目。通过50年的发展，纤维支气管镜已成为呼吸系统疾病诊断和治疗的重要工具，目前广泛应用于临床。纤维支气管镜诊疗是一项有创操作，可引起多种并发症。尤其是近年来随着纤维支气管镜介入治疗的开展，大咯血、严重低氧血症、死亡等严重并发症呈增加趋势，应该引起我们的高度重视。为此，本研究收集我院呼吸内科2011年1月～2016年4月纤维支气管镜检查与治疗的患者2753例，回顾分析纤维支气管镜检查与治疗所致的严重并发症及防治方法。现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2011年1月～2016年4月纤维支气管镜检查与治疗的呼吸内科门诊或住院患者2753例，其中男186