摘要
目的探讨纤维支气管镜在高位截瘫并呼吸衰竭患者中的应用。方法回顾性分析2014年1月至2016年2月因颈胸椎骨折高位截瘫并呼吸衰竭住院并行纤维支气管镜检查的64例患者的临床资料。56例患者需长期(>14 d)呼吸机辅助呼吸,8例患者颈、胸椎骨折术后3 d内脱离呼吸机,但需要吸氧。结果 64例患者中,气道大量分泌物或肺不张53例(其中31例需定期反复纤维支气管镜吸痰),气道充血、水肿,局部糜烂8例,痰痂阻塞气管导管2例,气道轻微渗血1例。53例经纤维支气管镜检查吸出气道分泌物后,肺部听诊及肺不张较检查前明显改善,呼吸状态明显好转;其余11例也经纤维支气管镜检查进行准确诊断和有效处理。本研究患者在纤维支气管镜检查中顺利完成痰液标本采集64例,未发生缺氧、心律失常和出血等操作并发症,纤维支气管镜治疗后通气和氧合明显改善。结论纤维支气管镜检查应用于高位截瘫并呼吸衰竭患者中,在维持呼吸道通畅、正确指导抗生素的选用、辅助诊断治疗中有积极作用。
Objective To investigate the application of fiber bronchoscope in patients with high paraplegia complicated with respiratory failure. Methods A retrospective analysis was made on clinical materials of 64 patients from January 2014 to February 2016 due to neck thoracic vertebrae fracture high paraplegia complicating with respiratory failure and had received fiber bronchoscope. Fifty-six patients needed long term（ 14 days） assisted mechanical ventilator and 8 patients were independent of breathing machine in 3 days after neck thoracic vertebra fracture operation,but still needed oxygen inhalation. Results Among the 64 patients,53 cases had a large amount of secreta in the airway or suffered from pulmonary atelectasis（ 31 cases needed periodical repeated fiber bronchoscope sputum suction）,8 cases suffered from airway congestion,edema and local erosion,2 cases suffered from sputum scab blocking the airway tube and 1 case suffered from airway slight errhysis. Fifty-three cases were treated by fiber bronchoscope sputum suction,after that,lung auscultation and atelectasis were improved significantly and the breathing state was evident better; the resting 11 cases were also treated by fiber bronchoscope for correct diagnosis and effective treatment. During the fiber bronchoscope examination,64 patients completed sputum specimen collection and there was no anoxia,arrhythmia,bleeding or other operation complications. After fiber bronchoscope treatment,the ventilation and oxygenation were evidently improved. Conclusion Fiber bronchoscope plays an active role in maintaining unobstructed respiratory tract and instructing selection of antibiotics and auxiliary diagnosis and treatment during the treatment process of patients with high paraplegia and respiratory failure.
出处
《临床医学》
CAS
2017年第2期15-17,共3页
Clinical Medicine
关键词
纤维支气管镜
脊髓损伤
高位截瘫
呼吸衰竭
机械通气
Fiber bronchoscope
Spinal cord injury
High paraplegia
Respiratory failure
Mechanical ventilation
