床旁纤维支气管镜结合支气管动脉造影栓塞术在大咯血并急性呼吸衰竭抢救中的应用

发布时间：2018-03-24 19:26

本文选题：纤维支气管镜　切入点：支气管动脉造影栓塞　出处：《广东医学》2017年06期

【摘要】：目的探讨床旁纤维支气管镜(简称纤支镜)和支气管动脉造影栓塞治疗在抢救大咯血并急性呼吸衰竭中的临床价值。方法对15例大咯血并急性呼吸衰竭病例通过紧急气管插管建立人工气道,呼吸机辅助通气,并同时运用床旁纤支镜检查治疗,吸引气道内积血或血块以畅通气道,明确出血原因及部位和局部止血,同时使用静脉止血药物及血管活性药物,对仍有出血者,行支气管动脉造影栓塞治疗。结果 15例病例中治愈11例,好转1例,其中经纤支镜成功止血4例,联合支气管动脉造影栓塞8例;死亡1例;2例自动出院放弃继续治疗。无一例出现术中并发症。结论床旁纤支镜结合支气管动脉造影栓塞治疗是抢救大咯血并急性呼吸衰竭患者的一种安全有效手段,值得临床推广。
[Abstract]:Objective to evaluate the clinical value of bronchofiberscope beside the bed and bronchial arteriography embolization in the treatment of massive hemoptysis and acute respiratory failure. Methods Fifteen patients with massive hemoptysis and acute respiratory failure were treated with bronchofiberscope and bronchial arteriography. Establishing artificial airways through emergency tracheal intubation, Ventilator assisted ventilation, and at the same time the use of bedside fiberoptic bronchoscopy, to attract blood clots in the airway to smooth the airway, to determine the cause and location of bleeding and local hemostasis, while using intravenous hemostatic drugs and vasoactive drugs, Results among 15 cases, 11 cases were cured, 1 case was improved, 4 cases were successfully hemostasis through bronchofiberscope, 8 cases were embolized by combined bronchoarteriography. 1 case died and 2 cases were discharged from hospital automatically. No complications occurred in the operation. Conclusion the treatment with bedside fiberoptic bronchoscopy and bronchial arteriography embolization is a safe and effective method to rescue patients with massive hemoptysis and acute respiratory failure. It is worth popularizing in clinic.
【作者单位】：汕头市中心医院呼吸内科;汕头市中心医院介入科;广州医科大学附属广州市第一人民医院呼吸内科;

【相似文献】