纤维支气管镜在先天性心脏病围手术期的应用  

Application of fiberoptic bronchoscope in patients with congenital heart disease during perioperative period

作　　者：陈煜[1] 林辰曦 田维敏[1] 陈琪[1] 赵红缨 黄萍[1] 林志青[1] 陈凌[1] CHEN Yu(Department of Pediatrics,Zhongshan hospital affiliated to Xiamen University,Xiamen,Fujian,361000,China)

机构地区：[1]厦门大学附属中山医院儿科,福建厦门361000

出　　处：《齐齐哈尔医学院学报》2018年第17期2016-2018,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨纤维支气管镜在先天性心脏病围手术期应用的价值和风险。方法回顾性分析2014年12月—2018年7月在本院行气管镜检查的先天性心脏病围手术期患儿共46例,分析检查结果、治疗结局和并发症。结果 46例先天性心脏病患儿中28例发现气道结构异常,6例术后撤机困难与气管/支气管狭窄和软化有关,但经长时间机械通气可逐步撤机。40例患儿存在气管支气管炎性改变,灌洗液发现多种病原体单独或混合感染。肺不张患儿中部分存在痰栓阻塞,予活检钳清除分泌物后肺复张。并发症方面仅见一过性氧饱和度下降和少量痰中血丝。结论先天性心脏病患儿常合并气道异常,气管镜可明确判断气道异常的类型和程度,同时进行清除分泌物治疗和病原学检查,并发症发生率低。Objective To explore the value and risk of fiberoptic bronchoscope applied in perioperative management of the patients with congenital heart disease. Methods 46 patients with congenital heart disease received fiberoptic bronchoscope examination during December 2014 and July 2018 were enrolled in this study,the results of examination and treatment and complications were analyzed. Results Airway anatomic abnormity was found in 28 patients. 6 patients with difficult ventilator weaning were related to tracheobronchial stenosis or tracheobronchomalacia,while the time for ventilator weaning extended to months.40 patients had tracheobronchial inflammation,and single or mixed pathogens were found in bronchoalveolar lavage fluid. Partial patients with atelectasis were confirmed with phlegm-induced airway obstruction and lung re-expansion gained after secretion clearance. Transient decrease in oxygen saturation and self-healing bloody sputum were noticed as complication.Conclusions Airway anatomic abnormity often occurs in patients with congenital heart disease. In addition to the low incidence of complication,fiberoptic bronchoscope helps to clarify the type and degree of airway abnormity,clear the obstructed airway and perform etiological examination.

关 键 词：纤维支气管镜 先天性心脏病 围手术期 

分 类 号：R541[医药卫生—心血管疾病]