纤维支气管镜提高经皮扩张气管切开术的安全性研究  

Study on the Safety of Fiberoptic Bronchoscopy in Improving Percutaneous Dilational Tracheostomy

作　　者：陈红发 刘陈发 姚勃挥 黎鹏飞 吴志超 CHEN Hong-fa;LIU Chen-fa;YAO Bo-hui;LI Peng-fei;WU Zhi-chao(Intensive Care Unit,Yujiang District People's Hospital of Yingtan City,Yingtan 335200,Jiangxi,China)

机构地区：[1]鹰潭市余江区人民医院重症医学科,江西鹰潭335200

出　　处：《医学信息》2024年第16期72-75,共4页Journal of Medical Information

基　　金：鹰潭市指导性科技计划项目(编号:2023-9-23164)。

摘　　要：目的探究纤维支气管镜在经皮扩张气管切开术中的应用价值。方法以2022年8月-2023年11月鹰潭市余江区人民医院收治的64例重型颅脑损伤(sTBI)昏迷患者为研究对象,经随机数字表法分为研究组(32例)与对照组(32例)。对照组行经皮导丝扩张钳气管切开术(GWDF)治疗,研究组则采用纤维支气管镜联合GWDF治疗,比较两组黏膜损伤程度、术后痰液黏稠度、术后24 h内切口出血程度、意识障碍程度、术后并发症。结果研究组黏膜损伤程度及术后痰液黏稠度评分均低于对照组,差异有统计学意义(P<0.05);研究组术后24 h内切口出血程度、意识障碍程度优于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率为9.38%,低于对照组的34.38%(P<0.05)。结论纤维支气管镜配合GWDF可减少其术后黏膜损伤程度及切口出血情况,降低sTBI昏迷患者的痰液黏稠度,改善患者意识障碍,降低术后并发症发生风险。Objective To explore the application value of fiberoptic bronchoscopy in percutaneous dilational tracheostomy.Methods A total of 64 coma patients with severe traumatic brain injury(sTBI)who were admitted to Yujiang District People's Hospital of Yingtan City from August 2022 to November 2023 were enrolled in the study.They were divided into study group(32 patients)and control group(32 patients)by random number table method.The control group was treated with percutaneous guide wire dilatation forceps tracheotomy(GWDF),while the study group was treated with fiberoptic bronchoscopy combined with GWDF.The degree of mucosal injury,postoperative sputum viscosity,incision bleeding within 24 h after operation,degree of disturbance of consciousness and postoperative complications were compared between the two groups.Results The degree of mucosal injury and postoperative sputum viscosity score in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The degree of incision bleeding and disturbance of consciousness within 24 hours after operation in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 9.38%,which was lower than 34.38%in the control group(P<0.05).Conclusion Fiberoptic bronchoscopy combined with GWDF can reduce the degree of postoperative mucosal injury and incision bleeding,reduce the sputum viscosity of coma patients with sTBI,improve patients'disturbance of consciousness,and reduce the risk of postoperative complications.

关 键 词：经皮扩张气管切开术 重型颅脑损伤 意识障碍 纤维支气管镜 痰液黏稠度 

分 类 号：R651.15[医药卫生—外科学]