摘要
目的 探究纤维支气管镜在重症医学科（ICU）中的应用的有效性及安全性.方法 2013年8月至2014年8月期间北京市海淀医院重症医学科收住患者492例,其中86例纳入研究.记录年龄、性别、急性生理与慢性健康评分（APACHE）、简明急性生理功能评分（SAPS）、疾病种类.同时收集纤维支气管镜应用指征、结果、并发症、操作地点、操作人员科室信息.收集病例资料,并对数据应用SPSS 16.0统计分析软件进行统计学分析.结果 共104例次纤维支气管镜操作纳入研究.纤维支气管镜在诊断性应用上有64％的有效率,在治疗性应用上有81％的有效率,总体诊疗有效率为72％.其中应用于肺炎32例次,有效率为51％;应用于经皮气管切开术导引26例次,有效率为100％;应用于肺不张20例次,有效率为75％;应用于气道探查18例次,有效率为75％;应用于困难气管插管导引5例次,有效率100％;应用于咳血3例次,有效率100％.外周血氧饱和度（SpO2）下降＞5％可见于65％的病例中,操作前外周血氧饱和度（SpO2）维持在94.0％±5.2％;操作中,SpO2最低维持在86.8％ ±8.4％（P＜0.000 1）;操作后SpO2维持在93.0％±4.5％（P=0.82）.其他并发症占3.9％.结论 纤维支气管镜在ICU的应用范围广,不良反应少,临床应用安全、有效.
Objective To evaluate the utility and safety of fiberoptic bronchoscopy （FOB） in an intensive care unit （ICU）.Methods From Aug 2013 to Aug 2014,out of 492 patients admitted into Beijing Haidian Hospital ICU,86 patients were included according to the study.Data including age,sex,APACHE,SAPS and Disease type,were processed using SPSS16.0.Results A total of 104 FOBs were performed in 86 patients P who were admitted to the ICU.FOB was useful in 64% of diagnostic procedures and 81% of therapeutic procedures,with an overall utility of 72%.The utility according to pneumonia in 32 cases,utility of 51%;percutaneous tracheostomy guidance in 26 cases,utility of 100%;atelectasis in 20 cases,utility of 75%;airway exploration in 18 cases,utility of 75%;hemoptysis in 3 cases,utility of 100%;and difficult airway intubation in 5 cases,utility of 100%.A decrease in pulse-oximeter oxygen saturation （SpO2） of 〉 5% during FOB was present in 65% cases.Mean SpO2 before FOB was 94.0% ±5.2%.During the procedure,the mean lowest SpO2 was 86.8% ± 8.4% （P 〈 0.000 1） and the mean postprocedural SpO2 was 93.0% ±4.5% （P =0.82）.The other minor complications were present in 3.9% of cases.Conclusions FOB has a great application field for the patients in ICU.The utility and safety of this operation is credible.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第29期2372-2374,共3页
National Medical Journal of China
基金
北京市优秀人才培养资助项目（2012D008005000005）
关键词
支气管镜
可重复性
结果
并发症
Bronchoscopes
Reproducibility of result
Complications
