床边纤维支气管镜在抢救呼吸系统急危重症患者中的应用.docVIP

床边纤维支气管镜在抢救呼吸系统急危重症患者中的应用 第6卷第4期 2010年4月 亚太传统医药 Asia—PacificTraditionalMedicine V01.6No.4 Apr.2010 床边纤维支气管镜在抢救呼吸系统 急危重症患者中的应用 林敏芳,洪旭初,徐顺贵,叶玲,林劲榕,杨萍 (福建省人民医院/福建中医学院附属人民医院呼科内科,福建福州350004) 摘要:目的:探讨床边纤维支气管镜在急诊抢救呼吸系统急,危重症患者的应用价值.方法:对床边纤支镜在 急诊抢救呼吸系统的急,危重症患者29例进行回顾性分析.结果:29例患者床边纤支镜急诊检查,其中纤维支 气管镜引导下经鼻气管插管3例(纤维支气管镜经口气管插管改经鼻气管插管1例),纤维支气管镜吸痰治疗在 慢性阻塞性肺疾病急性加重期的治疗1l例(其中9例行有创机械通气治疗),难治性重症肺部感染10例(其中昏 迷患者气管切开行床边纤维支气管镜灌洗术3例,痰栓致急性肺不张5例),纤维支气管镜肺泡灌洗在呼吸机相 关性肺炎中的应用3例,用纤维支气管镜灌洗辅助治疗重症支气管哮喘2例.结论:床边纤支镜抢救呼吸系统的 急危重症患者安全,有效,对危重病人的抢救起着重要的作用. 关键词:纤维支气管镜:呼吸系统:急危重症 中图分类号:R459.7文献标识码:A文章编号:1673—2197(2010)04—0047—03 ApplicationofBedsideFibrobronchoscopeinEmergencyBreathing SystemtoAcuteandCriticalPatients LinMinfang,HongXuchu,XuShungui,YeLing,LinJinrong,YangPing (DepartmentofRespiratoryMedicine,thePeoplesHospitalofFujianProvince,affiliatedhospitalofFujian UniversityofTraditionalChinesemedicine,Fuzhou,350001) Abstract:Purpose:Studytheapplicationofbedsidefibrobronchoscopeinemergencybreathingsystemtoacuteandcriticalpatients. Method:Theapplicationofbedsidefibrobronchoscopeinemergencybreathingsystemto29casesofacuteandcriticalpatientsiS analyzed.Result:29patientswereexaminedusingbedsidefibrobronchoscope.with3casestreatedbynasotrachealintubation(1casewas plannedtotreatedbyoral—endotrachealintubation.butwaseventuallytreatedbynasotrachealintubation).11casestreatedbysputum suctionusingbedsidefibrobronchoscopeintheexacerbationstageofchronicobstructivepulmonarydiseasef9casesinvolvinginvasive mechanicalventilation).10casesofrefractorypulmonaryinfection(3patientswithcomatreatedbylavageusingbedsidefibrobronchoscope aftertracheotomy,and5casesofacuteatelectasiscausedbysputumblockage),3casesofventilatorassociatedpneumoniatreatedby alveolarlavageusingbedsidefibrobronchoscope.and2casesofseverebronchialasthmatreatedbylavageusingbedside fibrobronchoscope.Conclusion:TheemergencybreathingsystemwithbedsidefibrobronchoscopeiSsafeandeffectiveforacuteand criticalpatients,andplaysanimportantroleintheemergencytreatmentoftheacutea