纤维支气管镜在救治氨气吸入性损伤患者中的应用  

Clinical application of fiberoptic bronchoscopy to remedy of inhalation injury of ammonia

作　　者：时靖峰[1] 滕小宝[1] 韩明锋[1] 冉献贵[1] 贾伟[1] 杨银屏[1] 时建[1] 

机构地区：[1]安徽省阜阳市第二人民医院呼吸科,安徽阜阳236015

出　　处：《中国内镜杂志》2009年第8期859-861,864,共4页China Journal of Endoscopy

摘　　要：目的探讨纤维支气管镜(纤支镜,FOB)在氨吸入性损伤患者救治中的诊断及治疗价值。方法32例患者纤支镜检查全部在床旁或纤支镜室进行,同时进行心电图及无创脉氧测定监护,并对所有氨吸入性损伤患者临床和纤支镜检查资料进行回顾性分析。结果32例患者行纤维支气管镜检查78人次,其中床旁检查42人次,气管内吸痰与支气管灌洗36人次。3例行气管切开、并经纤维支气管镜急诊检查及治疗12人次。临床病例分型为:轻度10例,中度14例,重度8例。纤支镜下吸入性损伤分型为:轻度11例,中度9例,重度8例,特重度4例。全部病例救治成功,无严重并发症发生及病例死亡。结论纤维支气管镜在氨吸入性损伤患者救治中具有较大诊断及治疗价值,且有简单易行、安全有效、可视性强等优点,值得临床推广应用。[ Objective ] To evaluate the clinical value of fiberoptie bronchoscopy （FOB） in the diagnosis and treatment of acute ammonia poisoning. [Methods] Clinical and endoscopic data of 32 cases with acute ammonia poisoning from May to December 2007 were analyzed retrospectively. FOB examination of the cases was performed at bedside or FOB room under electro-cardiac surveillance and monitoring of the atraumatic oxygen saturation. [ Results ] All the cases received FOB. FOB was carried out 76 times totally, including 42 times on bedside, 36 times of drawing sputum and bronchoalveolar lavage （BAL）. Three cases had incision of trachea and urgent endoscopic treatment 12 times. Clinical types included： mild degree in 10 cases, medium degree 14 cases and severe degree 8 cases. Different types of inhalation injury through bronehoscopy： mild degree in 11 cases, medium degree 9 cases, severe degree 8 cases, especially severe degree 4 cases. All cases were saved and treated successfully. There was neither severe operation related complication or death. [ Conclusions ] FOB examination plays an important role in the diagnosis and therapy for acute ammonia poisoning. It has such advantages as easy operation, clear visualized image, security and effectiveness. It is worthy of wide application in clinic.

关 键 词：纤维支气管镜 吸入性损伤:氨 

分 类 号：R608[医药卫生—外科学]