床旁纤维支气管镜联合机械通气治疗食道癌术后肺不张的临床应用  

Clinical Application of Bedside Fiberbronchoscopy Combined with Mechanical Ventilation on the Treatment of Pulmonary Atelectasis After Esophageal Cancer Operation

作　　者：甘春燕[1] 曾建明[1] 

机构地区：[1]德阳市人民医院呼吸内科,四川德阳618000

出　　处：《黑龙江医学》2014年第4期385-387,共3页Heilongjiang Medical Journal

摘　　要：目的 探讨床旁纤维支气管镜（简称纤支镜）联合机械通气治疗食道癌术后肺不张的效果及应用价值.方法 回顾性分析我科纤支镜室2003-03 ～ 2012-03间在机械通气下治疗40例食道癌术后肺不张,按是否给予纤支镜干预随机分为对照组与观察组,每组各20例.分析比较两组患者生命体征、血气分析及肺复张总有效率,并对结果采用统计学分析.结果 观察组治疗1h后心率、呼吸频率降低,血氧饱和度明显改善,2h、12 h血气分析结果动脉血氧分压明显上升,动脉血二氧化碳分压明显降低,疗效优于对照组（P＜0.05）;观察组肺复张总有效率85％ （17/20）,对照组总有效率40％（8/20）,观察组优于对照组（P＜0.05）.结论 在有创机械通气下行床旁纤支镜治疗食道癌术后肺不张疗效显著,创伤小,操作简单且安全性高,值得临床推广应用.Objective To explore the effect and value of bedside fiberbronchoscopy（bronchoscopy） combined with mechanical ventila- tion to the treatment of pulmonary atelectasis after esophageal cancer operation. Methods A retrospective analysis was done to 40 patients with pulmonary atelectasis after esophageal cancer operation who were treated with mechanical ventilation during March, 2003 from March, 2012. And patients were divided into the observation group and control group according to the treatment of bronchoscopy or not. Comparison and statistics analysis of vital signs, blood gas analysis and efficiency of pulmonary reexpansion was done. Results Heart rate and respira- tory frequency treatment were decreased, and the oxygen satuation were improved significantly in the control group. Arterial oxygen tension increased significantly and carbon dioxide partial pressure decreased significantly two and twelve hours after treatment. It was more effective than the control group（P 〈0.05）. The total efficiency of lung reexpansion was 85% （17/20） in observation group, and 40% （8/20）in control group（ P 〈 0. 05 ）. Conclusion It is more effective, minimally invasive, simple and safe of bronchoscopy to pulmonary atelectasis combined with mechanical ventilation. It deserves to be popularization and application in clinic.

关 键 词：食道癌术后肺不张 纤维支气管镜 有创机械通气 

分 类 号：R563.4[医药卫生—呼吸系统]