经气管导管旁路行纤支镜检查术的可行性和安全性

目的]探讨对机械通气的急症危重患者,经气管导管旁路行纤支镜检查术的可行性和安全性.方法]对经鼻气管插管（在纤支镜引导下）以及行机械通气治疗的呼吸衰竭危重患者或对疑有气道阻塞或痰多吸引效果不佳而经三通延长管、气管导管内途径行纤支镜检查难以耐受者共47例,在持续机械通气下,经气管导管旁路行纤支镜检查、清痰和支气管灌洗.结果]共操作47例次,进镜操作时间约15～20 min,术程顺利.通过调整氧浓度、潮气量,操作中各相应时间点的血氧饱和度、呼吸、心率和血压平稳（ P 〉0.05）;术后1 h血气明显改善（ P 〈0.05）.结论]在持续机械通气下,经导管旁行纤支镜检查术是安全可行的.

Feasibility and Safety of Fiberoptic Bronchoscopy via tracheal Catheter Bypass

Objeetive] To explore the feasibility and safety of fiberoptic bronchoseopy（FB） via tracheal catheter bypass for emergency critical patients during mechanical ventilation（MV）. Methods]Forty seven critical cases of respiratory failure（RF） underwent nasotracheal intubation assisted by FB and MV treatment. Some patients who were suspected to have airway obstruction, or had poor effect of suction for excessive phlegm, or could not tolerate FB via three-way extended tube and endotracheal catheter, received FB via tracheal catheter bypass, cleaning up of sputum and bronchial lavage under continuous MV. Results] Totally 47 cases were operated successfully and the operation time was 15-20min. After regulating the oxygen concentration and tidal volume, the PaO2, R, HR and Bp at each time points during operation were stable（ P 〈0.05）. The blood gas was improved significantly 1 hour after operation（ P 〈0.05）. Conclusion] Under continuous MV, FB via tracheal catheter bypass is safe and feasible.