床边支气管镜检查在急危重症病人抢救中的应用

目的：探讨床边支气管镜在急危重症病人抢救中的应用价值。方法：14例34例次急诊行床边支气管镜检查，对镜下吸痰前后床头X线及心电监护中SpO2动脉血气PaO2、PaCO2的变化进行比较分析，判断镜下吸痰的疗效。结果：镜下吸痰14例34例次中有效13例33例次，有效率92．7％。14例中10例急行床头X线检查，显示肺不张8例，镜下吸痰后肺复张显著。吸痰前后比较：SpO2〈94％的发生率由吸痰前的85．7％降至14．2％；低氧血症（SaO2％60mmHg）的发生率由吸痰前的28．6%降至7．1％。结论：对于术中、术后因痰栓、痰痂、血块阻塞气道引起急性肺不张诱发呼吸衰竭，行床边支气管镜镜下吸痰，效果良好。

Application of bedside fibrobronchoscopy on rescuing acute severe patients

Objective: To evaluate the effect of bedside fibrobronchoscopy on rescuing acute severe patients. Methods: Compared the results of bedside X-ray, electrocardia monitor and artery blood-gas analysis on 14 cases for 34 times before and after emergency bedside fibrobronchoscopic aspiration of sputum, to determine the affect of aspiration of sputum. Results:Fibrobronchoscopic aspiration of sputum was performed in 14 cases for 34 times, 13 cases for 33 times were effective, the effective rate was 92.7%. Bedside X ray showed: 10 cases were perform bedside X-ray, 8 cases appeared pulmonary atelectases before operation, and they were all significantly improved after operation; In artery blood-gas: the incidence rate of decreased SpO2(less than 94%) were 85. 7% before operation and only 14. 2% after operation; the incidence rate of hypoxymia (PaO2<60 mmHg) decreased from 28. 6% to 7.1%. Conclusion: Bedside bronchoscopic aspiration of sputum is applied to acute severe patients whose respiratory failure resulted form acute atelectases caused by sputum embolism, sputum scar or blood in operation and postoperative period and its effect is reliable.