CAJ | 학술논문

目的探讨几种有创方法用于术后进行呼吸道清洁的指征并比较其治疗效果.方法回顾性分析2002年1月至2006年12月曾接受纤维支气管镜(简称纤支镜)吸痰、环甲膜穿刺置管、气管插管或气管切开的112例患者的临床资料.其中男性95例,女性17例;年龄14～81岁,平均年龄(65.2±11.1)岁.观察PaO2SpO2和肺不张的改善情况,并比较不同有创方式进行呼吸道清洁的治疗效果.结果纤支镜吸痰组有效率40.0%(24/60),其中36例患者还需多次纤支镜吸痰或进一步的有创方式吸痰.气管插管组有效率31.2%(15/48),有11例患者还需环甲膜穿刺、22例患者需气管切开吸痰.气管插管组和纤支镜吸痰组的术后介入时间和疗效持续时间低于经环甲膜穿刺和气管切开组.结论全面分析患者的病情有助于合理选择有效的有创呼吸道清洁方式.经气管插管和纤支镜吸痰在短期缓解患者症状方面有一定的作用,可作为胸外科术后有创方式吸痰的首选.
목적 탐토궤충유창방법용우술후진행호흡도청길적지정병비교기치료효과.방법 회고성분석2002년1월지2006년12월증접수섬유지기관경(간칭섬지경)흡담、배갑막천자치관、기관삽관혹기관절개적112례환자적림상자료.기중남성95례,녀성17례;년령14～81세,평균년령(65.2±11.1)세.관찰PaO2SpO2화폐불장적개선정황,병비교불동유창방식진행호흡도청길적치료효과.결과 섬지경흡담조유효솔40.0%(24/60),기중36례환자환수다차섬지경흡담혹진일보적유창방식흡담.기관삽관조유효솔31.2%(15/48),유11례환자환수배갑막천자、22례환자수기관절개흡담.기관삽관조화섬지경흡담조적술후개입시간화료효지속시간저우경배갑막천자화기관절개조.결론 전면분석환자적병정유조우합리선택유효적유창호흡도청길방식.경기관삽관화섬지경흡담재단기완해환자증상방면유일정적작용,가작위흉외과술후유창방식흡담적수선.
Objective To compare the indications and therapeutic effects of several invasive interventions in treating postoperative sputum retention. Methods Bronchoscopy, erieothyroidotomy, intubation or tracheotomy was performed in 112 patients with postoperative sputum retention from January 2002 to December 2006. There were 95 male and 17 female patients. The age ranged from 14 to 81 years old with a mean of (65.2 ± 11.1 ) years old. Their clinical data were collected to prove the improvement of PaO2, Sp02, and pulmonary ateleetasis. Sputum clearance results of these invasive methods were compared as well. Results Bronehoseopies were effective in 24 out of 60 cases (40. 0% ) , while the rest 36 eases called for multiple bronehoseopies or other maneuvers. Tracheal intubations were effective in 31.2% ( 15/ 48 ) patients, among whom 11 patients required further erieothyroidotomies, and 22 patients required tracheotomies. Intubations and bronehoscopies resulted shorter intervention durations and efficacy durations, comparing with the other two methods. Conclusions Personalized risk analysis helps decision making in invasive interventions for postoperative sputum clearance. Tracheal intubations and broncheseopie clearance are helpful in short-term symptomatic relief and recommended the first choice in eases of postoperative sputum retentions.