CAJ | 학술논문

目的探讨选择性患侧肺支气管插管控压吹张治疗术后顽固性肺不张的临床效果.方法将嘉兴市第一医院2005年1月至2010年5月18例接受纤维支气管镜吸痰、胸腔闭式负压引流、拍背、吹气球等常规综合治疗7 d仍不能使患肺复张者在催眠镇痛术下行支气管插管选择性患侧肺控压吹张治疗,由胸部听诊及次日胸部X线片评判疗效.结果术后第2天复查X线胸片,15例患者(83.3%)萎陷肺已全部复张,3例患者萎陷侧肺复张不完全,经第2次控压膨肺治疗后2例复张成功(11.1%,总有效率94.4%),另1例患者经3次膨肺治疗仍无效(5.6%).期间患者生命体征稳定,无插管损伤及其他并发症发生.结论在催眠镇痛肌松下由纤维支气管镜引导选择性支气管插管控压吹张治疗术后顽固性肺不张是切实可行的.
목적 탐토선택성환측폐지기관삽관공압취장치료술후완고성폐불장적림상효과.방법 장가흥시제일의원2005년1월지2010년5월18례접수섬유지기관경흡담、흉강폐식부압인류、박배、취기구등상규종합치료7 d잉불능사환폐복장자재최면진통술하행지기관삽관선택성환측폐공압취장치료,유흉부은진급차일흉부X선편평판료효.결과 술후제2천복사X선흉편,15례환자(83.3%)위함폐이전부복장,3례환자위함측폐복장불완전,경제2차공압팽폐치료후2례복장성공(11.1%,총유효솔94.4%),령1례환자경3차팽폐치료잉무효(5.6%).기간환자생명체정은정,무삽관손상급기타병발증발생.결론 재최면진통기송하유섬유지기관경인도선택성지기관삽관공압취장치료술후완고성폐불장시절실가행적.
Objective To investigate the effect of bronchial intubation for constant-pressure expanding ipsilateral lung on postoperative intractable atelectasis. Methods For this prospective study, we recruited 18 patients with pulmonary atelectasis who could not been relieved by bronchoscopic suctioning,closed thoracic drainage, backslap, blowing hall and other routine treatments for over a week. After bronchial intubation, ipsilateral lung was expanded with a constant pressure. And the therapeutic effect was evaluated by chest radiographic examination and auscultation at the following day. Results Collapsed lung tissue were examined in 15 patients (83.3%) after the first treatment and in 2 patients ( 11. 1% ) after twice inflation. And another case failed even after three times treatment. During the procedure, the vital signs of all patients were stable and no complication occurred. Conclusion Constant-pressure expanding of ipsilateral lung during bronchial intubation is a safe and effective treatment for postoperative intractable atelectasis.