纤维支气管镜检在ICU中的应用价值  

Application value of fiberoptic bronchoscopy in intensive care unit

作　　者：苏春燕[1] 袁保生[1] 张宏伟[1] 于建华[1] 

机构地区：[1]中国中医科学院望京医院ICU,北京100102

出　　处：《中国内镜杂志》2009年第11期1222-1224,共3页China Journal of Endoscopy

摘　　要：目的探讨纤维支气管镜在ICU中的临床应用价值。方法对该院2007年5月～2009年6月在ICU行纤维支气管镜检查及治疗的病例作回顾性分析,对行该项操作的目的进行汇总,并对吸痰治疗前后血气分析指标及胸片的变化进行自身对照,经纤支镜留取痰标本与常规途径留取痰标本阳性率进行比较。结果共行纤维支气管镜检查及治疗206例次,吸痰及留取痰标本71例,单纯吸痰93例,吸痰治疗前后血气分析中pH、PaO2、PaCO2及SaO2等各项指标以及胸片检查均明显好转,经纤支镜留取的痰标本培养阳性率高于常规途径留取的痰标本(P<0.05);引导经口气管插管31例;发现气道狭窄4例、广泛气道塌陷1例,发现段支气管以上增生物3例,发现人工气道阻塞2例,发现气管食管瘘1例,无1例发生严重并发症。结论床边纤维支气管镜技术在ICU应用广泛,安全有效,具有重要的临床应用价值。[ Objective ] To investigate the application value of fiberoptic bronehoscopy in ICU. [ Methods ] The data of the eases receiving fiberoptic bronchoscopy and bronchoseopic treatment in the ICU from May 2007 to June 2009 were retrospectively analyzed. The objectives of fiberoptic bronchoscopy were summarized. The indexes of blood-gas analysis and chest X-ray before and after treatment were observed, and the positive rates of sputum samples getting from fiberoptic bronchoscopy compared with those from routine route. [Results] Fiberoptic bronchoscopy was performed on 206 patients, which included 71 cases with both sputum suction and culture, 93 cases with only sputum suction. The indexes of pH, PaO2, PaCO2, SaO2 and results of chest X-ray were improved significantly after sputum suction. The positive rate of sputum sample getting from fiberoptic bronchoseopy was obviously higher than that from routine method （P 〈0.05）. Orotracheal intubation with the aid of fiberopfic bronchoscope was performed on 31 patients. 4 cases were found with airway stenosis, 1 case with tracheal collapse, 3 cases with tracheal masses, 2 cases with artifical blockage and 1 case with tracheoesophageal fistula. There was no complication in any cases. [Conclusion] It is safe, effective, widely used and of great clinical value to perform fiberoptic broncboseopy on hospitalized patients in the ICU.

关 键 词：纤维支气管镜 ICU 气道管理 

分 类 号：R443.7[医药卫生—诊断学]