危重哮喘患者机械通气中支气管肺泡灌洗治疗的安全性研究  

Safety of bronchoalveolar lavage in patients with severe asthma undergoing invasive mechanical ventilation

作　　者：樊勋[1] 程小曲 张卫东[2] 

机构地区：[1]佛山市顺德中西医结合医院ICU,528333 [2]平顶山市第一人民医院呼吸内科

出　　处：《中国医师进修杂志（内科版）》2006年第1期28-30,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨危重哮喘并广泛小气道黏液栓或肺不张患者,在有创机械通气中行纤维支气管镜(纤支镜)诊疗的安全性。方法对12例危重哮喘患者,在有创机械通气中,将纤支镜从连接于气管插管和呼吸机回路管之间的三通接头的吸痰孔插入气道,经纤支镜作支气管肺泡灌洗术。结果共操作16例次,每次历时长达1h,均术程顺利、未发生并发症。术中及术后血气分析及相应时间点心率、血压分别与术前比较,术中无明显改变(P>0.05),术后显著好转(P<0.05)。结论危重哮喘患者有急需纤支镜诊疗指征时,及时在有创机械通气支持下行纤支镜诊治术,具有良好效果及可靠的安全性。Objective To study safety of treatment through bronchoclysis supported by invasive mechanical ventilation in patients suffering from serious asthma with extensive grume embolisms in small bronehioles or atelectasis. Method Twelve patients suffering from serious continual asthma were chosen to be supported by invasive mechanical ventilation, then made bronehoclysis by inserting fibrous bronehosoope through the suck phlegm hole of three directional tie - in which connected tracheal spile and breathing systern. Result Sixteen were finished smoothly without any intercurrent disease, each lasted about 1 hour. The artery blood analysis,HR and Bp during operation didn＇t have obvious changes comparing with those before operation （P 〉 0.05 ）, and all were improved after operations （ P 〈 0.05）. Conclusion When patients suffering from serious asthma have acute signs and have been treated by making fibrous bronchoclysis in time supported by invasive ventilation could get good effect and had credible safety.

关 键 词：危重哮喘 支气管镜 机械通气 支气管肺泡灌洗 血气分析 

分 类 号：R563.8[医药卫生—呼吸系统] R155[医药卫生—内科学]