纤维支气管镜治疗急危重症患者合并严重肺部感染的疗效观察

目的探讨纤维支气管镜（纤支镜）在急危重症合并严重肺部感染时的治疗效果。方法回顾支气管镜对60例重症患者合并重症肺感染时进行纤支镜引导下气道插管、换管,气道管理,重症肺炎的取痰培养、排痰及治疗,合并咯血的治疗,合并肺不张的治疗,总结临床经验。结果 16例经口气管插管困难患者经纤支镜引导插管成功。8例气管插管患者经纤支镜引导换管插管成功。60例重症肺部感染患者,经纤维支气管镜配合治疗,感染均得到有效控制。7例肺不张者经行纤支镜配合治疗6例肺复张。大咯血2例患者,经纤支镜局部止血处理,咯血均立即停止。60例患者肺部感染治愈52例,死于肺部感染2例。结论纤支镜对急危重症患者合并严重肺部感染时可协助气管插管,配合气道的管理,有效治疗难治性肺部感染、痰栓所致肺不张、大咯血等。是急危重症治疗中极有价值的工具。

Clinical observation on bronchoscopy treatment acute and critically ill patients with severe pulmonary infection

Objective To investigate the clinical efficacy of fiberbronchoscope in severe acute disease complicated with severe pulmonary infection. Metheds Clinical experience was summarized by reviewing the bronchoscope in 60 cases of severe patients complicated with severe pulmonary infection by bronchofiberscope guided tracheal intubation, tube replacement, airway management, severe pneumonia, sputum cultures from sputum and hemoptysis treatment, combined treatment, the treatment of pulmonary atelectasis. Results Sixteen cases of difficult orotracheal intubation with fiberoptic intubation successed. 8cases of tracheal intubation with fiberoptic tube intubation successed. In 60 patients with severe pulmonary infection patients, bronchoscopy with treatment, the infection was controlled effectively. In 7 patients with lung not by fiberbronchoscope in treatment of 6 cases with lung recruitment. 2 cases of hemoptysis patients, topical hemostatic treatment by bronchoscope, hemoptysis were immediately stop. In 60 cases of patients with pulmonary infection 52 cases were cured, 2 cases died of lung infection. Conclusion Bronchoscopy is a valuable tool in emergency treatment of acute and critically ill patients, with severe pulmonary infection can assist with tracheal intubation, airway management, effective in the treatment of refractory pulmonary infection, sputum bolt atelectasis, massive hemoptysis.