纤维支气管镜对右中叶肺不张的诊治价值(附50例报告)

目的：探讨应用纤维支气管镜检查术在右中叶肺不张诊断和治疗中的价值。方法：对50例右中叶肺不张患者应用纤维支气管镜进行诊断和治疗。结果：50例右中叶肺不张中非特异性炎症29例、肺癌12例、结核3例、异物1例、未确定诊断5例，总确诊率90％(45／50)；50例中33例经纤维支气管镜直视下局部治疗后复张，有效率66％(33／50)，术后未见严重并发症。结论：纤维支气管镜对右中叶肺不张有一定的临床诊断和治疗价值。     

用纤支镜为支气管哮喘患者作肺灌洗的安全性观察

本文对12例支气管哮喘病人作了22例次支气管肺泡灌洗,其中3例次为重度哮喘发作;8例次为中度发作[1];11例次为缓解期.灌洗方法在一般肺灌洗的基础上经过改良后,12例病人无1例死亡.11例次哮喘发作患者,灌洗后临床症状皆有不同程度改善.11例次缓解期病人,灌洗后皆无不良反应.凡哮喘时间较长者,均能灌洗出较大量脓痰栓.     

Nasotracheal intubation using fiberoptic bronchoscopy in infants and children

Journal of Anesthesia -     

纤维支气管镜检查确诊的气管、支气管结核41例分析

目的：通过分析纤维支气管镜下气管,支气管结核的表现,引起临床医生对此病的重视,提高诊断率,避免误诊和漏诊。方法：采用Olympus纤维支气管镜对气管,支气管进行常规检查,根据需要进行活检,刷检和灌洗。结果：41例中33例经活检,刷检和灌洗证实为结核,8例经抗结核治疗后病变吸收证实为结核。结论：纤维支气管镜检查及活检是目前诊断本病的重要方法。     

纤维支气管镜肺活检对周围及弥漫性肺病的诊断价值

目的 :探讨纤维支气管镜检查和经纤维支气管镜肺活检 (TBLB)对周围及弥漫性肺疾病的诊断价值。方法 :对 46 0例周围及弥漫性肺疾病患者 ,在无X线电视透视下行TBLB ,对临床资料及病理诊断结果进行回顾分析。结果 :46 0例周围及弥漫性肺疾病中有 35 1例明确了病因学的诊断 ,确诊率达 76 3% ,疾病种类主要有肺癌、肺结核、肺间质纤维化、肺结节病等 ,对临近胸膜的病变TBLB阳性率较低 ,并发症少见 ,仅有少量出血及发热 ,或偶有气胸。结论 :纤维支气管镜肺活检对周围及弥漫性肺疾病的诊断是一种可靠、安全、简便、经济、可重复操作的方法。     

Dysphagia in Parkinson's disease: Pharyngeal manometry and fiberoptic endoscopic evaluation

ObjectiveDysphagia is a common symptom in Parkinson's disease (PD) and it represents a negative prognostic factor because of its complications. This study is to evaluate pharyngeal dysphagia for boluses of various consistencies with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM) in a group of PD patients, making a comparison between the information provided by the two exams.MethodsGroup of 20 patients affected by PD was selected and initially subjected to a qualitative evaluation of the swallowing performing FEES. Subsequently, they were evaluated by PHRM to identify quantitative measures associated with pressures expressed by pharyngeal organs during swallowing. Values obtained in the study group were compared with those recorded in a group of 20 healthy subjects.ResultsStudy showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower than the control group (p<0.05) for all the boluses and consistency tested, in particular for the Tongue base and the Cricopharyngeal muscle. Pmean pre-swallowing pressure (represents the mean value of a contraction in which basal and maximal pressure where normally calculated) was significantly higher compared to normal subjects for the Tongue base and the Cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the Velopharynx and the Cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently to the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. Images displayed at the FEES, found the corresponding biomechanical explanations in the PHRM, which also allowed us to quantify the extent of the dysfunction, through the calculation of the pressures generated in the various structures studied.ConclusionPHRM is particularly useful in the early detection of dysphagia, when FEES may still show no evidence of abnormal swallowing.     

光导纤维支气管镜经口和经鼻气管插管患儿心血管反应的比较

目的比较小儿光导纤维支气管镜(FOB)经口和经鼻气管插管的心血管反应。方法选择美国麻醉医师协会(ASA)身体状态分级为Ⅰ级、在全身麻醉下施择期整形外科手术的患儿65例,随机分为经口组(n=36)和经鼻组(n=29)。在常规静脉麻醉诱导后实施FOB气管插管。测定麻醉诱导前(基础值)、后,气管插管时和气管插管后5 min内(测定间隔为1 min)血压(BP)和心率(HR),记录气管插管时间。结果经鼻组气管插管时间显著长于经口组(P<0.05)。FOB气管插管导致两组BP和HR均比麻醉诱导前基础值显著升高(P均<0.05)。与经口组相比,气管插管致BP增高和HR增快反应在经鼻组较轻,持续时间较短。经口组气管插管时BP和HR及观察过程中BP和HR最大值均显著高于经鼻组(P均<0.05)。结论FOB经口和经鼻气管插管均可引起小儿BP和HR显著升高,但FOB经鼻气管插管时心血管反应较FOB经口气管插管时轻。