应用Forgarty导管进行气道充气、测压定位气胸肺漏气支气管  

Forgarty catheter used for measuring located bronchus of pneumothorax air leakage and air way inflation

作　　者：金普乐[1] 葛晖[1] 胡文霞[1] 李斌[1] 

机构地区：[1]河北医科大学第四医院呼吸科,河北石家庄050011

出　　处：《中国内镜杂志》2012年第7期724-727,共4页China Journal of Endoscopy

摘　　要：目的探讨Forgarty导管球囊充液,气道内充气、测压定位气胸漏气支气管方法,并评价其效果及安全性。方法 40例气胸患者随机分为两组,均经纤维支气管镜(纤支镜)钳道插入Forgarty导管,采用导管球囊充液封堵靶支气管气流。A组:应用胸腔持续负压吸引定位肺漏气支气管。B组:在A组基础上,经导管向充液球囊前端支气管注气,测压定位肺漏气支气管。结果两组张力性和交通性气胸患者均成功定位。闭合性气胸中,A组定位成功率37.5%(3/8),B组89%(8/9),组间比较P<0.05。A组定位时间平均(11±4.1)min,B组平均(13±3.2)min,组间比较P>0.05。两组患者定位过程中均耐受良好。结论准确定位气胸肺漏气所属支气管是封堵成功的关键。Forgarty导管球囊充液,球囊前端气道内充气、测压是一种同样安全和更为准确的气胸肺漏气支气管定位新方法,特别适合于胸腔负压吸引时,引流管无明显气体溢出的患者。[ Objective ] To evaluate efficacy and safety of a new method to locate the bronchus of pulmonary air leakage by Forgarty catheter tamponading, gas injecting and pressure measuring in airway. [Methods] All of 40 cases with pneumothorax were randomly divided into two groups. Group A： The balloon of Forgarty catheter was filled with physiological saline and blocked air flow of target bronchus to detect broken bronchus of pneumothorax. Group B： Based on Group A, Injecting air via catheter and measuring endobronchial pressure in front of balloon to detect broken bronchus of pneumothorax. [ Results ] In Group B the success rate of closed pneumothorax was 89% （8/9） better than in Group A 37.5% （3/8） （P 〈0.05）, no any difference between both groups of open and tension pneumothorax （P 〉0.05）. In Group A the mean time of locating was （11±4.1） min, Group B （13±3.2） min （P 〈0.05）. Patients in both groups were well tolerated without any obvious adverse effects. [ Conclusion ] On patient with pneu- mothorax, the successful key is accurately locating the bronchus of air leakage. In Group B it was same safe, but more accurate to locate the bronchus of pulmonary air leakage and particularly suitable for patients who had chest negative pressure drainage, but no obvious gas was seen on drainage tube.

关 键 词：Forgarty导管 气胸 压力表 

分 类 号：R561.4[医药卫生—呼吸系统]