经纤维支气管镜操作孔供氧在急性心源性肺水肿患者半坐卧位气管插管中的临床研究  

Clinical application of oxygenation through operating hole of fiberoptic bronchoscopy in patients with acute cardi-ac pulmonary edema during endotracheal intubation in semi-supine position.

作　　者：赖业旺 陈朝文 陈佳娜 罗梦莉 陈树群[2] 陈耿滨 LAI Ye-wang;CHEN Chao-wen;CHEN Jia-na;LUO Meng-li;CHEN Shu-qun;CHEN Geng-bin(Department of Critical Medicine,Puning Overseas Chinese Hospital,Jieyang 515300,Guangdong,China;不详)

机构地区：[1]普宁华侨医院重症医学科,广东揭阳515300 [2]普宁华侨医院胸外科,广东揭阳515300

出　　处：《广东医学》2022年第5期618-621,共4页Guangdong Medical Journal

基　　金：揭阳市科技计划项目(YLWS017)。

摘　　要：目的观察经纤维支气管镜(纤支镜)操作孔供氧在急性心源性肺水肿患者半坐卧位下行纤支镜引导气管插管中的应用。方法选择急性心源性肺水肿患者45例,全部在半坐卧位下行纤支镜引导气管插管。采用随机数字表法分为两组,观察组27例采用经纤支镜操作孔供氧,对照组18例不采用经纤支镜操作孔供氧。比较两组患者于插管中最低指脉氧饱和度及插管后即时指脉氧饱和度,记录插管中是否发生心律失常及所用时间。结果经纤支镜操作孔供氧能够提高气管插管中最低指脉氧饱和度(P<0.01)及插管后即时指脉氧饱和度(P<0.01),缩短插管操作时间(P<0.01)。结论经纤支镜操作孔供氧可显著改善气管插管过程中的低氧血症,并通过高流量氧气的冲刷作用使视野更加清晰,显著减少插管时间,降低心律失常发生的可能,值得临床推广。Objective To observe the clinical efficacy of oxygen supply through the operation channel on patients with acute cardiogenic lung oedema(ACLE),who received intubation in semi-seated position(semi-Fowler's posi-tion)guided by fiberoptic bronchoscope(FOB).Methods There were 45 patients with ACLE admitted in our hospital from June 2020 to September 2021,and all received intubation guided by FOB in the semi-seated position.They were divided into two groups by random number table,27 patients in treatment group who received oxygen supply through the operation channel of FOB,while 18 patients in control group who were not.The lowest finger pulse oxygen saturation(SpO_(2))during intubation,immediate SpO_(2) after intubation,the incidence of arrhythmic disorders during intubation and the intubation time were compared between the two groups.Results The lowest SpO_(2) during intubation and immediate SpO_(2) after intubation and intubation time of the treatment group were significantly better than the control group(P<0.01).Conclusion Intubating with oxygen supply through the operation channel of FOB in semi-seated position could significantly improve the hypoxemia during intubation.The flushing effect of high-flow oxygen makes the vision clearer,which reduces the intubation time.It might also reduce the incidence of arrhythmias.

关 键 词：纤维支气管镜引导气管插管 经纤维支气管镜操作孔供氧 急性心源性肺水肿 半坐卧位 

分 类 号：R459.7[医药卫生—急诊医学] R562.1[医药卫生—治疗学]