CAJ | 학술논문

目的初步探讨大型C臂机实时引导下经超细支气管镜肺大疱减容术的安全性及影响因素.方法 8例肺大疱患者均在大型C臂机实时引导下经超细支气管镜工作通道先后通过微导管向目标细支气管注入利多卡因、自身血、纤维蛋白原、凝血酶.从注药顺序、注入混悬液量的选择及并发症等方面评价其安全性及影响因素.结果 8例患者均出现不同程度的发热,热度不超过38.5℃；7例出现咽喉痛；5例高剂量组及1例低剂量组患者出现不同程度阻塞性肺炎及肺大疱周边组织肺不张；3例出现血丝痰,以上均未做任何处理而自愈.无头痛、胸痛、机化性肺炎、永久性肺不张、气胸、肺脓肿、慢性阻塞性肺疾病急性加重(AECOPD)等发生.随诊半年,无论是低剂量组还是高剂量组均无严重并发症发生.结论大型C臂机实时引导下经超细支气管镜生物学肺大疱减容术为临床提供了一种安全的治疗方法.值得在有条件医院推广应用.
목적 초보탐토대형C비궤실시인도하경초세지기관경폐대포감용술적안전성급영향인소.방법 8례폐대포환자균재대형C비궤실시인도하경초세지기관경공작통도선후통과미도관향목표세지기관주입리다잡인、자신혈、섬유단백원、응혈매.종주약순서、주입혼현액량적선택급병발증등방면평개기안전성급영향인소.결과 8례환자균출현불동정도적발열,열도불초과38.5℃；7례출현인후통；5례고제량조급1례저제량조환자출현불동정도조새성폐염급폐대포주변조직폐불장；3례출현혈사담,이상균미주임하처리이자유.무두통、흉통、궤화성폐염、영구성폐불장、기흉、폐농종、만성조새성폐질병급성가중(AECOPD)등발생.수진반년,무론시저제량조환시고제량조균무엄중병발증발생.결론 대형C비궤실시인도하경초세지기관경생물학폐대포감용술위림상제공료일충안전적치료방법.치득재유조건의원추엄응용.
Objective To preliminary explore the safety and influence factors of large C arm machine of timely guide ultrafine bronchoscopy lung bullous minus let technique.Methods 8 lung bullae patients with large Carm were timely under the guidance by ultrafine bronchoscope working channel has passed to the target micro-catheter injection of lidocaine bronchioles,their own blood,fibrinogen,thrombin.From the injection sequence,the amount of selection into the suspension and complications were used to evaluate the safety aspects and influencing factors.Results 8 patients suffered from varying degrees of heat,which was no more than 38.5 ℃ ;7 cases of sore throat;five cases of high-dose group and 1 case of low-dose group of patients with varying degrees of obstructive pneumonia and pulmonary bullous peripheral tissues of atelectasis ;3 cases stained sputum,were not doing any more than self-healing process.Headache,chest pain,organizing pneumonia,permanent lung atelectasis,pneumothorax,lung abscess,AECOPD,etc.didn't occur.Followed up for six months,whether low-dose group or high-dose group were no serious complications.Conclusion Large C-arm timely guidance by ultrafine bronchoscope biology of lung volume reduction surgery for bullae can provide a safe and less complications of treatment.It is worthy for conditional hospital application.