摘要
目的探讨使用改良气管导管治疗中央气管狭窄引起急性呼吸衰竭的疗效。方法对16例不同原因造成中央气管狭窄导致急性呼吸衰竭的住院患者,通过胸部 X 线片、胸部 CT 以及纤维支气管镜了解中央气管狭窄的部位和范围后,选用合适的硅胶吸引管剪裁制成导管,再经纤维支气管镜引导导管通过狭窄部位,建立人工气管。结果治疗后患者呼吸困难迅速缓解,动脉血氧分压从(39±12)mm Hg=0.133 kPa)增至(72±10)mm Hg,血氧饱和度从(75±13)%增至(95±3)%,动脉血二氧化碳分压则从(102±21)mm Hg 下降到(62±13)mm Hg,有效率达100%。除2例气管小量出血外,没有其他严重并发症发生,15例患者存活,1例由于并发严重的多器官功能衰竭而死亡。结论使用改良气管导管治疗中央气管引起的急性呼吸衰竭,可以短时间内缓解急性呼吸困难,对狭窄的中央气管进行扩张成型,为后续治疗节省了气管球囊扩张术的费用。
Objective To investigate the curative effect of modified tracheal catheter in acute respiratory failure caused by central airway stenosis. Methods 16 cases inpatient with acute respiratory failure caused by central airway stenosis were involved. Found out the position and range of stenosis of central airway by X-ray and CT of chest and fiberbronchoscope, chose the suitable silicon suction tube and cut it to make a tracheal catheter, then guided the catheter through the stenosis by fiberbronchoscope to construct artificial airway. Results The dyspnea of all 16 cases of acute respiratory failure caused by central airway stenosis could by relieved in short time,the PaO2 raised from （39 ±12） mm Hg to （72± 10） mm Hg,SaO2 raised from （75±13）% to （93±3）%, PaCO2 dropped from （102±21） mm Hgto （62＋13） mmHg after therapy. The effective rate is 100%. There was no other serious complication except for 2 cases of little amount of bleeding in trachea. 15 cases survived and one died of serious multisystem organ failure. Conclusions The use of modified tracheal catheter in treatment of acute respiratory failure caused by central airway stenosis can relieve the acute dyspnea in short time, it also can dilate central airway, save the cost of tracheal balloon dilatation for the follow-up therapy.
出处
《中华全科医师杂志》
2006年第9期542-544,共3页
Chinese Journal of General Practitioners
关键词
气管狭窄
呼吸功能不全
改良气管导管
Tracheal stenosis
Respiratory insufficiency
Modified tracheal catheter
