[纤维支气管镜在重症监护病房的应用及疗效分析]

[Analysis on utility and efficacy of fiberoptic bronchoscopy in intensive care unit].

作者信息

Yan Weifeng, Qin Long, Liu Qiumin, Zhang Yingping

机构信息

Intensive Care Unit, Beijing Haidian Hospital, Beijing 100083, China.

Intensive Care Unit, Beijing Haidian Hospital, Beijing 100083, China; Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2015 Aug 4;95(29):2372-4.

PMID:26711073

Abstract

OBJECTIVE

To evaluate the utility and safety of fiberoptic bronchoscopy (FOB) in an intensive care unit (ICU).

METHODS

From Aug 2013 to Aug 2014, out of 492 patients admitted into Beijing Haidian Hospital ICU, 86 patients were included according to the study. Data including age, sex, APACHE, SAPS and Disease type, were processed using SPSS16.0.

RESULTS

A total of 104 FOBs were performed in 86 patients P who were admitted to the ICU. FOB was useful in 64% of diagnostic procedures and 81% of therapeutic procedures, with an overall utility of 72%. The utility according to pneumonia in 32 cases, utility of 51%; percutaneous tracheostomy guidance in 26 cases, utility of 100%; atelectasis in 20 cases, utility of 75%; airway exploration in 18 cases, utility of 75%; hemoptysis in 3 cases, utility of 100%; and difficult airway intubation in 5 cases, utility of 100%. A decrease in pulse-oximeter oxygen saturation (SpO2) of >5% during FOB was present in 65% cases. Mean SpO2 before FOB was 94.0%±5.2%. During the procedure, the mean lowest SpO2 was 86.8%±8.4% (P<0.000 1) and the mean postprocedural SpO2 was 93.0%±4.5% (P=0.82). The other minor complications were present in 3.9% of cases.

CONCLUSIONS

FOB has a great application field for the patients in ICU. The utility and safety of this operation is credible.

摘要

目的

评估纤维支气管镜检查（FOB）在重症监护病房（ICU）中的实用性和安全性。

方法

2013年8月至2014年8月，在北京海淀医院ICU收治的492例患者中，根据研究纳入86例患者。使用SPSS16.0处理包括年龄、性别、急性生理与慢性健康状况评分系统（APACHE）、简化急性生理学评分（SAPS）和疾病类型等数据。

结果

86例入住ICU的患者共进行了104次纤维支气管镜检查。纤维支气管镜检查在64%的诊断操作和81%的治疗操作中有用，总体实用性为72%。在32例肺炎患者中，实用性为51%；在26例经皮气管切开术引导中，实用性为100%；在20例肺不张患者中，实用性为75%；在18例气道探查中，实用性为75%；在3例咯血患者中，实用性为100%；在5例困难气道插管患者中，实用性为100%。65%的病例在纤维支气管镜检查期间脉搏血氧饱和度（SpO2）下降>5%。纤维支气管镜检查前平均SpO2为94.0%±5.2%。在操作过程中，平均最低SpO2为86.8%±8.4%（P<0.000 1），操作后平均SpO2为93.0%±4.5%（P=0.82）。其他轻微并发症出现在3.9%的病例中。