老年肺纤维化患者纤维支气管镜检查血氧饱和度减低易感染性探讨及护理对策  

Susceptibity to Oxygen Desaturation and Nursing during Bronchoscopy in Elderly Patients with Pulmonary Fibrosis

作　　者：吴少银[1] 宋梅[1] 郑婵如[1] 陈赛玉[1] 陈赛曼[1] 

机构地区：[1]汕头大学医学院第二附属医院呼吸内科,广东汕头515041

出　　处：《河北医学》2010年第10期1258-1261,共4页Hebei Medicine

摘　　要：目的:探讨在可曲性纤维支气管镜检查(FFB)中,动脉血氧饱和度减低的原因及其护理措施。方法:经脉搏血氧饱和度仪(简称血氧仪)持续监测336例病人的血氧饱和度(SpO2)并记录,分析SpO2下降与各种临床参数和原有肺疾病的关系。结果:在336例中,86例(22%)有过一次性SpO2下降(SpO2<90%的时间大于10s),年龄大于65岁者,55%有过一次性SpO2下降,低氧血症发生率明显高于年龄低于65岁组(27%),P<0.05。与患有其他肺疾病者相比较,肺纤维化(IIP)组出现SpO2下降的危险性较大(P<0.05)。多因素分析表明,年龄和(IIP)分别是SpO2下降的独立危险因素,而多数病人(94%)不需要常规吸氧。结论:虽然纤维支气管镜检查是安全的,但老年、肺纤维化是发生低氧血症的高危因素。在临床实践中通过完善纤维支气管镜的操作流程,提高操作水平,细心的病情观察,良好真心的护理及健康教育指导,能有效的降低老年肺纤维化病人纤支镜检查低氧血症的发生。Objective： To examine the causes of arterial oxygen desaturation and nursing during FFB. Method： 336 patients who underwent FFB without intervention. Arterial oxygen saturation （ SpO2 ） was continuously monitored by using oximetry with a recording system. Analyzed the relationship between a reduction in SpO2 during FFB and various clinical parameters or background lung diseases. Result： Of the 336 patients.86（22% ） had an episode of oxygen desaturation （ SPO2〈90% over 10s）. Of patients over 65 years old,55% had an episode of oxygen desaturation,which was significantly higher than 27% observed in the patients less than 65 years old （ P〈 0.05 ）. Patients with pulmonary fibrosis had a higher risk of desaturation （55%） compared to patients with other complications or patient without any complication（P〈0.05）. Multi- variable analysis revealed that both age and pulmonary fibrosis were independent predictor of oxygen desaturation. However, the majority of the patients （94%） did not require routine oxygen supplementation. Conclusion： Although FFB is safe and does not require oxygen supplementation in most cases, age over 65 years and pulmonary fibrosis are high risk factors for significant oxygen Desaturation during FFB. To perfect operating techniques for fiberoptic bronchoscopy, to enhance postoperative care, and to observe the condition carefully, good nursing care and health education guidance ,it can prevent the occurrence of oxygen desaturation.

关 键 词：支气管镜检查 血氧饱和度减低 肺纤维化 护理 

分 类 号：R473.5[医药卫生—护理学]