气管切开后拔管困难原因分析及处理-中国内镜杂志.PDFVIP

第23卷 第1期                                                                           Vol. 23  No. 1 中国内镜杂志   2017年1月                                                                    China Journal of Endoscopy                                                                                  Jan. 2017 DOI: 10.3969/j.issn.1007-1989.2017.01.019 文章编号 ：  1007-1989（2017）01-0090-05 气管切开后拔管困难原因分析及处理 青刚，黄万秀 （四川省广安市人民医院 呼吸内科，四川 广安 638000） 摘要 ：目的  探讨可弯曲支气管镜（纤维支气管镜/电子支气管镜，简称支气管镜）在气管切开术后 拔管困难诊治中的意义。方法  回顾性分析17例经可弯曲支气管镜检查确诊和治疗的气管切开术后拔管困 难患者的临床资料。结果  17例拔管困难患者，除1例脑外伤气管上端瘢痕挛缩伴闭锁拔管失败外；其余16 例患者均成功拔管，拔管成功率94.1%。除1例患者出现支架移位、1例患者拔管后出现呼吸困难外，余无不 良事件发生，无致死性并发症发生。结论  可弯曲支气管镜在气管切开术后拔管困难患者诊治中起着重要作 用，且安全可靠，值得临床推广。 关键词 ： 可弯曲支气管镜；气管切开术；支气管镜下治疗；拔管困难 中图分类号 ： R768.1                                               文献标识码 ： B Cause and treatment in difficult decannulation of tracheotomy patients Gang Qing, Wan-xiu Huang (Department of Respiratory Medicine, the People’s Hospital, Guang’an, Sichuan 638000, China) Abstract: Objective To observe the value of flexible bronchoscopy (fiberoptic bronchoscopy/electronic bron choscopy, abbreviation bronchoscopy) in the diagnosis and treatment of patients with decannulation difficult after tracheotomy. Methods 17 cases with decannulation difficult after tracheotomy which were diagnosed and treated by flexible bronchoscopy were reviewed and evaluated. Result Among the 17 patients with decannulation difficult, except