中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2015年
4期
286-289
,共4页
气胸%支气管镜检查%选择性支气管封堵术
氣胸%支氣管鏡檢查%選擇性支氣管封堵術
기흉%지기관경검사%선택성지기관봉도술
Pneumothorax%Bronchoscopy%Select bronchial occlusion
目的 探讨经支气管镜呼气未二氧化碳(EtCO2)探查对难治性气胸胸膜瘘口引流支气管的定位价值.方法 选择我院2013年1-6月经球囊导管探查阴性的难治性气胸4例,经支气管镜送入采样导管、运用旁流EtCO2测定法来定位气胸破裂口引流支气管.以患侧主支气管EtCO2作为参考值,分别测定不同叶段支气管EtCO2,然后向EtCO2明显降低的支气管注入不同剂量的自身全血+凝血酶,观察封堵结果、判断EtCO2探测效果.结果以自体血封堵成功作为判断EtCO2探测阳性的标准,与患侧主支气管EtCO2相比较,4例患者共有7支叶、段支气管出现EtCO2下降,幅度为2～8 mmHg(1 mmHg=0.133 kPa),向上述支气管注入自身全血+凝血酶均封堵成功.结论EtCO2是一种新的引流支气管的探查方法,可以作为球囊探查失败时的补救方法.
目的 探討經支氣管鏡呼氣未二氧化碳(EtCO2)探查對難治性氣胸胸膜瘺口引流支氣管的定位價值.方法 選擇我院2013年1-6月經毬囊導管探查陰性的難治性氣胸4例,經支氣管鏡送入採樣導管、運用徬流EtCO2測定法來定位氣胸破裂口引流支氣管.以患側主支氣管EtCO2作為參攷值,分彆測定不同葉段支氣管EtCO2,然後嚮EtCO2明顯降低的支氣管註入不同劑量的自身全血+凝血酶,觀察封堵結果、判斷EtCO2探測效果.結果以自體血封堵成功作為判斷EtCO2探測暘性的標準,與患側主支氣管EtCO2相比較,4例患者共有7支葉、段支氣管齣現EtCO2下降,幅度為2～8 mmHg(1 mmHg=0.133 kPa),嚮上述支氣管註入自身全血+凝血酶均封堵成功.結論EtCO2是一種新的引流支氣管的探查方法,可以作為毬囊探查失敗時的補救方法.
목적 탐토경지기관경호기미이양화탄(EtCO2)탐사대난치성기흉흉막루구인류지기관적정위개치.방법 선택아원2013년1-6월경구낭도관탐사음성적난치성기흉4례,경지기관경송입채양도관、운용방류EtCO2측정법래정위기흉파렬구인류지기관.이환측주지기관EtCO2작위삼고치,분별측정불동협단지기관EtCO2,연후향EtCO2명현강저적지기관주입불동제량적자신전혈+응혈매,관찰봉도결과、판단EtCO2탐측효과.결과이자체혈봉도성공작위판단EtCO2탐측양성적표준,여환측주지기관EtCO2상비교,4례환자공유7지협、단지기관출현EtCO2하강,폭도위2～8 mmHg(1 mmHg=0.133 kPa),향상술지기관주입자신전혈+응혈매균봉도성공.결론EtCO2시일충신적인류지기관적탐사방법,가이작위구낭탐사실패시적보구방법.
Objective To evaluate the effect of end-tidal carbon dioxide (EtCO2) detection for location of the leading bronchus in patients with pneumothorax.Methods Transbronchoscopic EtCO2 detection was performed in 4 patients with intractable pneumothorax in whom transbronchoscopic balloon detection failed to localize the leading bronchus.A specific bronchus was suspected to be the leading bronchus when its EtCO2 value was significantly lower than that of the main bronchus of the affected lung.After the pleural air leakage was successfully sealed by bronchial occlusion of the suspected bronchus,the EtCO2 was confirmed to indicate the leading bronchus.Results Transbronchoscopic EtCO2 detection successfully located the leading bronchus in all 4 patients.Conclusion Transbronchoscopic EtCO2 detection is a new method of locating the leading bronchus in patients with intractable pneumothorax.
