[1]陈红发,刘陈发,姚勃挥,等.纤维支气管镜提高经皮扩张气管切开术的安全性研究[J].医学信息,2024,37(16):72-75.[doi:10.3969/j.issn.1006-1959.2024.16.015]
　CHEN Hong-fa,LIU Chen-fa,YAO Bo-hui,et al.Study on the Safety of Fiberoptic Bronchoscopy in Improving Percutaneous Dilational Tracheostomy[J].Journal of Medical Information,2024,37(16):72-75.[doi:10.3969/j.issn.1006-1959.2024.16.015]
点击复制

纤维支气管镜提高经皮扩张气管切开术的安全性研究()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年16期
页码:
72-75
栏目:
论著
出版日期:
2024-08-15

文章信息/Info

Title:
Study on the Safety of Fiberoptic Bronchoscopy in Improving Percutaneous Dilational Tracheostomy
文章编号:
1006-1959（2024）16-0072-04
作者:
陈红发; 刘陈发; 姚勃挥; 黎鹏飞; 吴志超
鹰潭市余江区人民医院重症医学科，江西 鹰潭 335200
Author(s):
CHEN Hong-fa; LIU Chen-fa; YAO Bo-hui; LI Peng-fei; WU Zhi-chao
Intensive Care Unit,Yujiang District People’s Hospital of Yingtan City,Yingtan 335200,Jiangxi,China
关键词:
经皮扩张气管切开术; 重型颅脑损伤; 意识障碍; 纤维支气管镜; 痰液黏稠度
Keywords:
Percutaneous dilational tracheostomy; Severe traumatic brain injury; Consciousness disorders; Fiberoptic bronchoscopy; Sputum viscosity
分类号:
R651.1+5
DOI:
10.3969/j.issn.1006-1959.2024.16.015
文献标志码:
A
摘要:
目的 探究纤维支气管镜在经皮扩张气管切开术中的应用价值。方法 以2022年8月-2023年11月鹰潭市余江区人民医院收治的64例重型颅脑损伤（sTBI）昏迷患者为研究对象，经随机数字表法分为研究组（32例）与对照组（32例）。对照组行经皮导丝扩张钳气管切开术（GWDF）治疗，研究组则采用纤维支气管镜联合GWDF治疗，比较两组黏膜损伤程度、术后痰液黏稠度、术后24 h内切口出血程度、意识障碍程度、术后并发症。结果 研究组黏膜损伤程度及术后痰液黏稠度评分均低于对照组，差异有统计学意义（P＜0.05）；研究组术后24 h内切口出血程度、意识障碍程度优于对照组，差异有统计学意义（P＜0.05）；研究组术后并发症发生率为9.38%，低于对照组的34.38%（P＜0.05）。结论 纤维支气管镜配合GWDF可减少其术后黏膜损伤程度及切口出血情况，降低sTBI昏迷患者的痰液黏稠度，改善患者意识障碍，降低术后并发症发生风险。
Abstract:
Objective To explore the application value of fiberoptic bronchoscopy in percutaneous dilational tracheostomy.Methods A total of 64 coma patients with severe traumatic brain injury (sTBI) who were admitted to Yujiang District People’s Hospital of Yingtan City from August 2022 to November 2023 were enrolled in the study. They were divided into study group (32 patients) and control group (32 patients) by random number table method. The control group was treated with percutaneous guide wire dilatation forceps tracheotomy (GWDF), while the study group was treated with fiberoptic bronchoscopy combined with GWDF. The degree of mucosal injury, postoperative sputum viscosity, incision bleeding within 24 h after operation, degree of disturbance of consciousness and postoperative complications were compared between the two groups.Results The degree of mucosal injury and postoperative sputum viscosity score in the study group were lower than those in the control group, and the differences were statistically significant (P<0.05). The degree of incision bleeding and disturbance of consciousness within 24 hours after operation in the study group were better than those in the control group, and the differences were statistically significant (P<0.05). The incidence of postoperative complications in the study group was 9.38%, which was lower than 34.38% in the control group (P<0.05).Conclusion Fiberoptic bronchoscopy combined with GWDF can reduce the degree of postoperative mucosal injury and incision bleeding, reduce the sputum viscosity of coma patients with sTBI, improve patients’ disturbance of consciousness, and reduce the risk of postoperative complications.

参考文献/References:

[1]张檀,丁钰,袁利群.直视下经皮扩张气管切开术在神经外科重症患者中的应用[J].中国现代神经疾病杂志,2023,23(6):503-508.[2]杜玉英,时惠,任钰.康复医学科气管切开重症患者影响拔管的多因素分析[J].中国康复医学杂志,2021,36(6):670-675.[3]杨林,秦逊,向琰,等.光索辅助经皮扩张气管切开术在神经重症患者中的应用[J].局解手术学杂志,2020,29(5):368-373.[4]李海艳,翟翔.经皮扩张气管切开术在困难气道患者中的应用[J].临床耳鼻咽喉头颈外科杂志,2019,33(10):993-995.[5]Fiorelli A,Bove M,Noro A,et al.Dilation of tracheal stenosis below tracheostomy tube with Dolphin percutaneous tracheostomy kit : Tracheal stenosis treated with Dolphin PDT[J].Gen Thorac Cardiovasc Surg,2020,68(6):655-658.[6]廖舒,杜贵鹏,康永慧.超声引导下经皮气管切开术对ICU患者血清C-反应蛋白、白细胞介素-8和肿瘤坏死因子-α的影响[J].河北医药,2021,43(15):2313-2315,2319.[7]张欣欣,罗源,杨庆斌,等.纤维支气管镜吸痰联合肺泡灌洗对重症肺炎并发呼吸衰竭患者疗效、CPIS评分及血清炎性指标水平的影响[J].山东医药,2022,62(4):86-88.[8]赵鑫,赵保建,谢泽敏,等.纤维支气管镜在经皮扩张气管切开术中的应用[J].临床麻醉学杂志,2022,38(11):1147-1151.[9]胡慧芳,程炜炜,余夏威,等.床边支气管镜下吸痰和灌洗治疗老年重症肺炎患者的临床观察[J].老年医学与保健,2022,28(1):144-147.[10]韩振,蔡波,梁宇平,等.纤维支气管镜吸痰联合肺泡灌洗对重症肺炎并发呼吸衰竭患者疗效及安全性观察[J].贵州医药,2023,47(3):352-353.[11]张明,孙兴良,赵靖,等.神经重症康复病房气管切开术后拔管困难患者的临床特点分析[J].中华物理医学与康复杂志,2023,45(6):511-516.[12]孙雪东,孟东亮,严一核,等.超声定位纤维支气管镜引导下经皮扩张气管切开术在高呼气末正压患者中的应用[J].浙江医学,2021,43(6):645-648.[13]谢忠志,黄寨,秦文波,等.俯卧位通气联合纤维支气管镜肺泡灌洗在ICU重型颅脑损伤术后肺不张中的应用效果[J].广西医学,2020,42(16):2092-2094.[14]林占元,任楠.纤维支气管镜肺泡灌洗术在小儿MPP合并肺不张中的效果观察[J].贵州医药,2020,44(7):1127-1128.[15]冯娟,田秀文,曹念,等.纤维支气管镜吸痰与肺泡灌洗联用对肺癌术后肺部感染患者炎性因子及呼吸功能的影响[J].西部医学,2021,33(7):1056-1059,1064.[16]邓晓慧,田巍,葛晓竹,等.纤维支气管镜吸痰联合肺泡灌洗对高龄慢性阻塞性肺疾病合并重症肺炎患者的疗效观察[J].中国医药,2021,16(4):535-539.[17]付茂亮,张娜娜,刘紫微,等.超声评估纤维支气管镜引导下气管切开的临床研究[J].中华危重病急救医学,2020,32(8):1013-1015.[18]俞彩娣,张思泉,张海邻.纤维支气管镜吸痰治疗重症肺部感染患者的临床疗效研究[J].中华医院感染学杂志,2015(12):2774-2776.[19]陈凯.重症肺部感染患者采取纤维支气管镜吸痰联合肺泡灌洗的临床效果[J].中国医学工程,2018,26(1):64-66.[20]孙瑞,李艳芳,于利国,等.呼气末正压联合床边纤维支气管镜对脑卒中后气管切开患者的影响[J].神经损伤与功能重建,2022,17(7):426-428.[21]张飞,孔琳熙,王旭东.纤维支气管镜引导经皮扩张气管切开术在重症监护病房的应用研究[J].中国临床医生杂志,2022,50(8):925-928.

相似文献/References:

[1]姜浩斌.小脑幕切开术配合大骨瓣减压术治疗 重型颅脑损伤的效果分析[J].医学信息,2018,31(14):116.[doi:10.3969/j.issn.1006-1959.2018.14.034]
　JIANG Hao-bin.Analysis of the Effect of Large Bone Flap Decompression Assisted by Tentorial Incision for Severe Craniocerebral Injury Neurosurgery[J].Journal of Medical Information,2018,31(16):116.[doi:10.3969/j.issn.1006-1959.2018.14.034]
[2]刘瑞芳,赵 华,史红娟,等.益生菌联合早期肠内营养在重型颅脑损伤中的应用[J].医学信息,2019,32(24):25.[doi:10.3969/j.issn.1006-1959.2019.24.009]
　LIU Rui-fang,ZHAO Hua,SHI Hong-juan,et al.Application of Probiotics Combined with Early Enteral Nutrition in Patients with Severe Head Injury[J].Journal of Medical Information,2019,32(16):25.[doi:10.3969/j.issn.1006-1959.2019.24.009]
[3]伍荣乐.重症超声评估对重型颅脑损伤去骨瓣减压术后患者血管反应性、血流状态的影响[J].医学信息,2022,35(21):77.[doi:10.3969/j.issn.1006-1959.2022.21.017]
　WU Rong-le.Effect of Severe Ultrasound Evaluation on Vascular Reactivity and Blood Flow Status in Patients with Severe Craniocerebral Injury After Decompressive Craniectomy[J].Journal of Medical Information,2022,35(16):77.[doi:10.3969/j.issn.1006-1959.2022.21.017]
[4]樊学海.重型颅脑损伤手术治疗的研究[J].医学信息,2021,34(14):63.[doi:10.3969/j.issn.1006-1959.2021.14.018]
　FAN Xue-hai.Research on Surgical Treatment of Severe Head Injury[J].Journal of Medical Information,2021,34(16):63.[doi:10.3969/j.issn.1006-1959.2021.14.018]
[5]霍 利,丁立浩,嵇雪莱.去大骨瓣减压联合天幕裂孔切开对重型颅脑损伤合并脑疝患者神经功能及预后的影响[J].医学信息,2023,36(04):132.[doi:10.3969/j.issn.1006-1959.2023.04.026]
　HUO Li,DING Li-hao,JI Xue-lai.Effect of Large Decompressive Craniectomy Combined with Tentorium Cerebelli Hiatus Incision on Neurological Function and Prognosis in Patients with Severe Traumatic Brain Injury Complicated with Cerebral Hernia[J].Journal of Medical Information,2023,36(16):132.[doi:10.3969/j.issn.1006-1959.2023.04.026]
[6]温五梅,郭党红,刘 鸷,等.穴位电刺激联合吞咽功能训练对重型颅脑损伤后吞咽障碍患者吞咽功能的影响[J].医学信息,2023,36(10):179.[doi:10.3969/j.issn.1006-1959.2023.10.041]
　WEN Wu-mei,GUO Dang-hong,LIU Zhi,et al.Effect of Acupoint Electrical Stimulation Combined with Swallowing Function Training on Swallowing Function in Patients with Dysphagia After Severe Craniocerebral Injury[J].Journal of Medical Information,2023,36(16):179.[doi:10.3969/j.issn.1006-1959.2023.10.041]

更新日期/Last Update: 1900-01-01