老年人腹部手术后并发肺不张的纤维支气管镜介入治疗分析  

Treatment of abdominal operation-complicated pulmonary atelectasis with fibrobronchoscopy in elderly patients

作　　者：胡铭荣[1] 陈玺华[1] 季巧金[1] 

机构地区：[1]杭州市第二人民医院普外科,310015

出　　处：《中华老年医学杂志》2007年第9期656-657,共2页Chinese Journal of Geriatrics

摘　　要：目的总结老年人腹部手术后并发肺不张的纤维支气管镜（纤支镜）介入治疗经验。方法对16例老年人腹部手术后并发肺不张的临床资料进行回顾性分析。结果16例中,术后2～3d并发肺不张14例,均行纤支镜检查明确是支气管内痰液阻塞所致,经介入灌洗吸痰治疗而治愈。术后4d并发肺不张1例,因患者家属拒绝纤支镜介入处理,后并发肺部严重感染、脓胸,最终经胸腔闭式引流、抗感染等治疗4个月后好转。术后7d发现肺不张1例,因症状轻微、肺部感染不重,经加强抗感染等保守治疗而治愈。结论老年人腹部手术后要高度警惕肺不张的发生;对术后早期并发肺不张的患者应尽早给予纤支镜介入检查并灌洗吸痰治疗,效果满意。Objective To summarize the experience of treating abdominal operation-complicated pulmonary atelectasis with fibrobronchoscopy in elderly patients.Methods The clinical data of 16 elderly patients with atelectasis after abdominal operation were retrospectively analyzed.Results Atelectasis was found in 14 cases at the 2^nd or 3^rd day after abdominal operation,and caused by sputum blockage,and finally cured by fibrobronchoscopic lavage and sputum aspiration.One case atelectasis was diagnosed at the 4^th postoperation day,and the patient＇s family member refused to treat with fibrobronchoscopy.Then severe pneumonia combined thorax abscess happened,and finally was cured with thorax drainage and antibiotic treatment for four months.One case atelectasis was diagnosed at the 7^th postoperation day,and cured with conservative method because of mild symptom and mild lung infection.Conclusions We should pay attention to atelectasis after abdominal operation in elderly patients.Early occurred atelectasis after abdominal operation should be treated with fibrobronchoscopic lavage and sputum aspiration as soon as possible.

关 键 词：肺不张 支气管镜检查 手术后并发症 

分 类 号：R686[医药卫生—骨科学]