支气管哮喘中的纤维支气管镜检查。需谨慎。

Fiberoptic bronchoscopy in bronchial asthma. A word of caution.

作者信息

Sahn S A, Scoggin C

出版信息

Chest. 1976 Jan;69(1):39-42. doi: 10.1378/chest.69.1.39.

DOI:10.1378/chest.69.1.39

Abstract

Three instances of intense laryngospasm and bronchospasm occurred as a result of fiberoptic bronchoscopic examination in three patients with quiescent bronchial asthma. The indications for the procedure were hemoptysis in one patient and lobar collapse in two. It is likely that vagally mediated reflex laryngospasm and bronchoconstriction occur when irritant receptors are mechanically stimulated by the bronchoscope. Therefore, in the asthmatic population with its increased airway reactivity, indications for fiberoptic bronchoscopy should be absolute, and the procedure should be performed under optimal conditions. A rationale for minimizing the risk of this procedure in patients with bronchial asthma is discussed.

摘要

在3例静止期支气管哮喘患者中，因纤维支气管镜检查发生了3次严重的喉痉挛和支气管痉挛。手术指征为1例咯血，2例肺叶萎陷。当支气管镜机械刺激刺激感受器时，可能会发生迷走神经介导的反射性喉痉挛和支气管收缩。因此，在气道反应性增加的哮喘患者中，纤维支气管镜检查的指征应是绝对的，并且该手术应在最佳条件下进行。本文讨论了将支气管哮喘患者该手术风险降至最低的基本原理。