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目的探讨纤维支气管镜进行支气管肺泡灌洗治疗刺激性气体致重度中毒性肺水肿的可行性和临床疗效。方法通过对16例刺激性气体导致重度中毒性肺水肿的患者进行纤维支气管镜支气管肺泡灌洗,观察患者的术前、术中、术后2 h动脉血气指标、影像学及临床症状变化。结果肺泡灌洗后2 h,动脉血气PaO_2明显增高,PaCO_2变化不大,术前和术中的PaO_2、PaCO_2无明显的改变,术后24 h X线胸片肺部阴影明显减少,16例患者中,13例治愈,1例好转,2例死亡,治愈率为81%。结论纤维支气管镜支气管肺泡灌洗有利于清除气道有害物质,改善患者的换气和通气功能,是一种安全、疗效确切的方法。
Objective To investigate the feasibility and clinical efficacy of bronchial bronchoalveolar lavage (BAL) for the treatment of severe toxic pulmonary edema caused by irritant gas. Methods Bronchial bronchoalveolar lavage was performed on 16 patients with severe toxic pulmonary edema induced by irritant gas. The changes of arterial blood gas index, imaging and clinical symptoms were observed before, during and 2 h after operation. Results At 2 h after bronchoalveolar lavage, arterial blood gas PaO 2 was significantly increased, while PaCO 2 did not change much. There was no significant change in PaO 2 and PaCO 2 before and during the operation. The lung shadow of X-ray was significantly decreased 24 h after operation, and 16 patients Of the 13 patients who were cured, 1 improved and 2 died, with a cure rate of 81%. Conclusion Bronchofibroscope bronchoalveolar lavage is conducive to the removal of harmful substances in the airway and the improvement of ventilation and ventilation in patients. It is a safe and effective method.