吞吸式支气管造影法的研究与应用  

A New Technique of Bronchoradiography with a Thin Plastic Tube

作　　者：王基林[1] 张庆[1] 魏伟[2] 

机构地区：[1]青岛市人民医院,266001 [2]青岛医学院第二附属医院

出　　处：《医学影像学杂志》1997年第2期96-97,共2页Journal of Medical Imaging

摘　　要：目的：改革支气管造影插管法和应用水溶性造影剂．因旧式支气管造影法插管时病人痛苦极大。不利于支气管造影的应用。材料与方法：把一软细的塑胶管借助于生理功能“半自动”“飘”入气管内。（1）吞管：将管的远端吞咽到食道；（2）退管；透视下拉管后退．使管的远端停止在喉口的上方；（3）吸管：深呼气后猛一吸气，导管远端便会在强气流的作用下转向气管；（4）进管：插入的导丝可将导管送至支气管；结果：由于管细、柔软，从口吞管能快速通过咽喉，病人无痛苦、无窒息感。由于定位走向准确，能有效地麻醉主气管，所以导管进入气管时一般不咳嗽；管细可以进行选择性造影；适合应用水溶性有机碘造影剂，造影剂在肺内被吸收。结论：本技术简单易行，病人容易接收。Purpose: The author invented a new technique of semi-automatic intubation of soft and slender plastic tube through the month and finally down into the trachea for bronchoradiography. Material and methods: The procedures of intubation are: 1)Place the metallic tipped tube in patient's nlouth and then ask the patient to swallow the tube down into the esophagus. 2)Under fluorosoopy the tube is being pulled gently upwards so that the metallic tip is seen just at the level of the larynx. Slowly instill about 2 ml 2% lidocaine and ask the patient to make deep inhala tions. 3)Ask the patient while in standing position to bend forwards and lift up the head and then inhale suddenly and vigorously then the air flow will send the dube into the trachea. Now again instill 2ml lidocaine. 4) Insert the stilette to the very tip and send the tube further down the air way. Under fluroscopy the tip of the tube could be placed at exact the spot wanted, then inject contrast agent and take films. Results and Conclusion: The advantages of this new technique are 1) The sofe and slender tube is being swallowedeasily and with no discomfort. 2 ) With tracheal surface anesthesla. there will be no coughing during intubation. 3 ) Clear images of seleeted bronchial segment (s ) could be obtained. 4 )Smaller amount of contrast medium is sufficient.

关 键 词：吞吸式支气管造影法 水溶性造影剂 吞吸法 支气管影象 

分 类 号：R655.3[医药卫生—外科学]