纤维支气管镜在ICU机械通气患者中的应用

目的观察纤维支气管镜在重症监护病房（Intensive Care Unit,ICU）机械通气患者应用时的检查治疗作用及安全性。方法收录我院ICU病房2008年1月～2009年6月收治的35例行机械通气治疗的患者行纤维支气管镜检查治疗,对检查治疗前后各项指标的变化进行监测,包括平均动脉压、经皮血氧饱和度、心率变化。结果本组共行35例共42次纤支镜检查治疗,成功41次,包括：肺部感染24例;气管内支架置入术2例;肺不张4例;经明确诊断肺部肿瘤和食管-气管瘘各1例;出血2例;肺挫伤1例。行纤支镜检查治疗后,即刻平均动脉压、经皮血氧饱和度下降,心率增高,均有统计学意义（P〈0.05）,半小时后平均动脉压、经皮血氧饱和度、心率与术前相比无统计学意义（P〉0.05）,均无严重并发症。结论纤支镜在ICU机械通气患者中有较好的应用价值,且比较安全。

Clinical Application of Bronchoscope for Mechanically Ventilated Patients in the Intensive Care Unit

Objective To investigate the value of the diagnostic and therapeutic utility of bronchoscopy for mechanically ventilated patients in intensive care unit （ICU） and to evaluate the safety in critically ill patients.Methods Mechanically ventilated patients admitted to the ICU from January 2008 to June 2009 underwent bronchoscopy. Before and after examination or treatment performed, the results and the changes of vital parametes were monitored. Results A total 35 cases with ventilation were recruited,including 24 cases of pneumonia,2 cases of airway stents,4 cases of pulmonary atelectasis,1 case of esophago-trachea fistula,1 case of lung cancer,2 cases of hemoptysis and 1 case of pulmonary contusion.After examing and treatment of bronchoscope, MAP and SPO2 declined and HR increased.This was statistically significant（P0.05）.Half an hour later, There was no statistically significant（P0.05） for MAP,SPO2 and HR compared with preoperative one.Conclusion There are obvionsly clinical values of fiberoptic bronchoscopy and fiberobronchoscope therapy for mechanically ventilated patients in ICU.