支气管镜肺泡灌洗在淹溺患者中的应用价值

目的探讨纤维支气管镜肺泡灌洗对淹溺患者的治疗效果。方法总结蚌医附院ICU近5年来淹溺患者行纤维支气管镜（简称纤支镜）支气管肺泡灌洗（简称BAL）治疗15例,观察灌洗前后动脉血气（如PaO2、PaCO2、pH值）结果,并结合疗效标准。结果BAL治疗后动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）较前明显改善,差异有统计学意义（P〈0.01）,术中除短暂的血氧饱和度（SaO2）降至85%以外,未见其他严重不良反应。疗效显著13例,有效1例,无效1例,总有效率93%。结论纤支镜肺泡灌洗用于淹溺患者能达到良好的治疗效果,是一种行之有效的治疗方法,可以在临床上推广应用,但术中须注意观察、加强监护。

Appliance of Bronchoalveolar Lavage for Drowning Patients with Bronchoscope

Objective To explore the effect of bronchoalveolar lavage for drowning patients with bronchoscope.Methods 15 drowning patients in ICU received bronchoalveolar lavage（BAL） with bronchoscope in the last 5 years were retrospectively analyzed.The results of arterial blood gas analysis,such as PaO2,PaCO2,and pH were monitored.Results PaO2 was obviously improved and PaCO2 distinctly decreased after BAL.There was significant difference of blood gas analysis（P0.01） before and after treatment.There were no serious adverse reactions,except short SaO2 lowing down to 85% during the operation.Of 15 cases,13 with obvious effect;1 with certain effect;and 1 without any effect.The gross effective rate was 93%.Conclusion It was safe and effective for bronchoalveolar lavage to treat drowning patients.It can be applied in clinic,but must be monitored and warded during the operation.