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目的 :探讨危重症并急性呼吸衰竭纤支镜治疗的效果及安全性。方法 :30例危重症包括脑梗塞并冠心痛心功能Ⅲ～Ⅳ级 2 4例 ;急性左心衰 (控制后 6～ 8h) 3例 ;急性心肌梗塞 (2周 ) 2例 ;阵发室性及室上性心动过速 1例。所有患者均因患有严重肺部感染导致急性呼吸衰竭而采用纤支镜治疗。结果 :30例患者经纤支镜治疗后 ,均取得满意疗效 ,SpO2 由治疗前的 0 .86 6 3± 0 .0 46 6升至 0 .96 2 6± 0 .0 317,与治疗前比较差异具有非常显著性 (P <0 .0 0 1)。结论 :危重症并急性呼吸衰竭应用纤支镜治疗效果显著 ,我们认为只要操作手法熟练 ,对于心、脑的危重病及老年体弱并有痰阻导致急性呼吸衰竭并因此使原发病加重如出现心衰、严重心律失常者仍可应用纤支镜技术。
Objective: To evaluate the efficacy and safety of bronchofiberscopy in critically ill patients with acute respiratory failure. Methods: 30 cases of critical illness including cerebral infarction and coronary heart disease grade Ⅲ ~ Ⅳ 24 cases; acute left heart failure (control 6 ~ 8h) in 3 cases; acute myocardial infarction (2 weeks) in 2 cases; paroxysmal ventricular And supraventricular tachycardia in 1 case. All patients were treated with bronchoscopy because of acute respiratory failure due to severe pulmonary infection. Results: All patients achieved satisfactory results after bronchofiberscopy. SpO2 increased from 0.86 6 3 ± 0. 0 466 before treatment to 0 .96 2 6 ± 0. 0 317 before treatment The difference was significant (P <0. 001). Conclusion: The treatment of critically ill patients with acute respiratory failure using fiberoptic bronchoscopy is effective. We believe that as long as the skilled operation, for the heart, brain and critically ill elderly and frail elderly with sputum resistance lead to acute respiratory failure and thus aggravate the primary disease such as Heart failure, severe arrhythmia can still be applied to bronchoscopy.