全身麻醉双腔支气管下电子纤维支气管镜联合肺支气管动脉栓塞介入治疗支气管扩张大咯血的临床应用研究  

Clinical Application of Double Lumen Subbronchial Bronchoscopy Combined with Pulmonary Bronchial Artery Embolization in the Treatment of Massive Hemoptysis with Bronchiectasis Under General Anesthesia

作　　者：田家勇 TIAN Jiayong(Department of Critical Care Medicine,Linshu County People's Hospital,Linyi 276700,China)

机构地区：[1]山东省临沭县人民医院重症医学科,临沂276700

出　　处：《中国医药指南》2024年第13期19-22,共4页Guide of China Medicine

基　　金：山东省医药卫生科技发展计划项目(202017011084)。

摘　　要：目的 探讨全身麻醉双腔支气管下电子纤维支气管镜联合肺支气管动脉栓塞介入在支气管扩张大咯血治疗中的应用。方法 按照治疗方式的不同将2019年10月至2023年10月我院收治的56例支气管扩张大咯血患者分为4组,A组实施内科保守治疗,B组实施单纯纤维支气管镜止血治疗,C组实施单纯支气管动脉栓塞术治疗,D组则采取全身麻醉双腔支气管下电子纤维支气管镜联合肺支气管动脉栓塞介入治疗,对比四组治疗效果。结果 与A、B、C组相比,D组临床总有效率较高,D组全咯血量较少、肺动脉压较低、停止血液流动时间较长、住院时间较短,D组不良反应发生率较低(P <0.05)。治疗前、治疗中,四组血气指标比较差异无统计学意义(P> 0.05);治疗后1 h及治疗后1 d,与A、B、C组相比,D组PaO_(2)均较高,PaCO_(2)均较低(P <0.05)。结论 通过采取全身麻醉双腔支气管下电子纤维支气管镜联合肺支气管动脉栓塞介入治疗支气管扩张伴大咯血患者可获得突出的综合治疗效果,患者的血气功能指标得到明显调节及改善,且操作期间并无明显不良反应,整体安全性有保证。Objective To investigate the use of electronic fiberoptic bronchoscopy combined with pulmonary bronchial artery embolization intervention under general anesthesia with double-lumen bronchus in the treatment of bronchiectasis with hemoptysis.Methods According to different treatment methods,56 patients with bronchiectasis and massive hemoptysis treated in our hospital from October 2019 to October 2023 were divided into 4 groups.Group A received conservative medical treatment,group B received simple bronchoscopic hemostasis,and group C received simple bronchial artery embolization.Group D was treated with general anesthesia and double-lumen subbronchial electronic fiber bronchoscopy combined with pulmonary bronchial artery embolization,and the therapeutic effect of the four groups was compared.Results Compared with groups A,B and C,the total clinical effective rate of group D was higher,the total amount of hemoptysis in group D was lower,the pulmonary artery pressure was lower,the blood flow stopping time was longer,the hospital stay was shorter,and the incidence of adverse reactions in group D was lower(P<0.05).There was no significant difference in blood gas indexes between the four groups before and during treatment(P>0.05).At 1 h and 1 d after treatment,PaO_(2) and PaCO_(2) in group D were higher and lower than those in groups A,B and C(P<0.05).Conclusions The treatment of bronchiectasis with hemoptysis by double-lumen subbronchial electronic fiberoptic bronchoscopy under general anesthesia combined with pulmonary bronchial artery embolization can obtain outstanding comprehensive therapeutic effect,the patient's blood gas function indexes have been significantly regulated and improved,and there is no obvious adverse reaction during the operation,and the overall safety is guaranteed.

关 键 词：全身麻醉双腔支气管下电子纤维支气管镜 肺支气管动脉栓塞介入 支气管扩张大咯血 

分 类 号：R562[医药卫生—呼吸系统]