中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
5期
521-525
,共5页
王继旺%查王健%齐栩%李梅梅%周林福%黄茂
王繼旺%查王健%齊栩%李梅梅%週林福%黃茂
왕계왕%사왕건%제허%리매매%주림복%황무
气管狭窄%可弯曲支气管镜%介入治疗%呼吸衰竭
氣管狹窄%可彎麯支氣管鏡%介入治療%呼吸衰竭
기관협착%가만곡지기관경%개입치료%호흡쇠갈
Tracheal stenosis%Flexible bronchoscopy%Interventional treatment%Respiratory failure
目的 探讨喉罩通气全身麻醉下经可弯曲支气管镜介入治疗气管严重狭窄导致的呼吸衰竭的治疗效果并评价其有效性、安全性.方法 回顾性分析2009年9月至2012年3月16例因气管严重狭窄导致的呼吸衰竭收治于南京医科大学第一附属医院的患者介入治疗前和治疗后临床资料.喉罩通气全身麻醉下,经喉罩进出可弯曲支气管镜,通过支气管镜工作孔道进行冷冻治疗、电灼术、球囊扩张及自膨胀金属支架置入等综合呼吸介入治疗,根据患者CT和气管镜资料评估介入治疗前后气管狭窄程度及气促症状评分值.计量资料以均数±标准差((x-)±s)表示,治疗前后两组间均数比较采用配对t检验.结果 16例气管严重狭窄导致的呼吸衰竭患者经呼吸介入治疗后气管阻塞程度由术前的(85.0±8.4)％下降至(20.9±7.6)％(P＜0.01),气促症状评分由术前(3.9±0.3)降至(2.4±0.5)(P＜0.01).介入治疗过程中未出现1例大出血、死亡等严重并发症.结论 对于气管狭窄导致的呼吸衰竭患者,喉罩通气全身麻醉下经可弯曲支气管镜进行呼吸介入治疗安全、有效.
目的 探討喉罩通氣全身痳醉下經可彎麯支氣管鏡介入治療氣管嚴重狹窄導緻的呼吸衰竭的治療效果併評價其有效性、安全性.方法 迴顧性分析2009年9月至2012年3月16例因氣管嚴重狹窄導緻的呼吸衰竭收治于南京醫科大學第一附屬醫院的患者介入治療前和治療後臨床資料.喉罩通氣全身痳醉下,經喉罩進齣可彎麯支氣管鏡,通過支氣管鏡工作孔道進行冷凍治療、電灼術、毬囊擴張及自膨脹金屬支架置入等綜閤呼吸介入治療,根據患者CT和氣管鏡資料評估介入治療前後氣管狹窄程度及氣促癥狀評分值.計量資料以均數±標準差((x-)±s)錶示,治療前後兩組間均數比較採用配對t檢驗.結果 16例氣管嚴重狹窄導緻的呼吸衰竭患者經呼吸介入治療後氣管阻塞程度由術前的(85.0±8.4)％下降至(20.9±7.6)％(P＜0.01),氣促癥狀評分由術前(3.9±0.3)降至(2.4±0.5)(P＜0.01).介入治療過程中未齣現1例大齣血、死亡等嚴重併髮癥.結論 對于氣管狹窄導緻的呼吸衰竭患者,喉罩通氣全身痳醉下經可彎麯支氣管鏡進行呼吸介入治療安全、有效.
목적 탐토후조통기전신마취하경가만곡지기관경개입치료기관엄중협착도치적호흡쇠갈적치료효과병평개기유효성、안전성.방법 회고성분석2009년9월지2012년3월16례인기관엄중협착도치적호흡쇠갈수치우남경의과대학제일부속의원적환자개입치료전화치료후림상자료.후조통기전신마취하,경후조진출가만곡지기관경,통과지기관경공작공도진행냉동치료、전작술、구낭확장급자팽창금속지가치입등종합호흡개입치료,근거환자CT화기관경자료평고개입치료전후기관협착정도급기촉증상평분치.계량자료이균수±표준차((x-)±s)표시,치료전후량조간균수비교채용배대t검험.결과 16례기관엄중협착도치적호흡쇠갈환자경호흡개입치료후기관조새정도유술전적(85.0±8.4)％하강지(20.9±7.6)％(P＜0.01),기촉증상평분유술전(3.9±0.3)강지(2.4±0.5)(P＜0.01).개입치료과정중미출현1례대출혈、사망등엄중병발증.결론 대우기관협착도치적호흡쇠갈환자,후조통기전신마취하경가만곡지기관경진행호흡개입치료안전、유효.
Objective To investigate the efficiency and safety of intervention with flexible bronchoscope under general anesthesia by using laryngeal mask in patients with severe tracheal stenosis induced respiratory failure.Methods A total of 16 in-patients with respiratory failure caused by severe tracheal stenosis admitted from September 2009 to March 2012 were retrospectively reviewed.A comprehensive bronchoscopic intervention for the complete patency of airway was successfully performed with various techniques such as cryotherapy,electrocautery,balloon dilatation,and implantation of selfexpanding metal stents under genersl anesthesia by using laryngeal mask.The efficiency of comprehensive bronchoscopic intervention and dyspnea score were evaluated by chest CT scan and bronchoscopic examination before and after the treatment.Data were expressed as ((x-)± s).Paired t test was used for statistical analysis of the data.Results The degrees of tracheal stenosis and dyspnea score before and after intervention were (85.0±8.4)％ vs.(20.9±7.6)％ (P＜0.01) and (3.9±0.3vs.2.4±0.5,P＜ 0.01),respectively.There were no life-threatening complications occurred including massive haemorrhage.Conclusions It is an effective and safe technique to resolve the tracheal stenosis-induced respiratory failure with intervention by using flexible bronchoscope under general anesthesia with laryngeal mask,and it is a promising interventional treatment for clinic application.
