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目的探索与评估无痛纤支镜技术在慢性呼吸衰竭患者中的应用及安全性。方法选取60例住院COPD患者;动脉血氧分压<60 mmHg,动脉血二氧化碳分压>50 mmHg;吸氧或不吸氧氧饱和度达到90%以上;必须行纤支镜检查以确诊或须经纤支镜介入治疗检查者,实施无痛纤支镜检查或须经纤支镜介入治疗,记录其前后氧饱和度、心率、血压的变化、耐受时间、完成情况的观察。结果 60例患者中,术前均存在呼吸衰竭,其中50例氧饱和度低于90%(其中1例低至83%,1例85%其余均在86%~89%之间),25例能达到90%。术中50例能耐受,2例氧饱和度降至40%后不恢复,经简易呼吸机辅助呼吸5 min后上升至90%以上,9例氧饱和度降至60%~80%经抬高下颌,畅通呼吸道,加大吸氧浓度,5~20 min恢复90%以上。结论对于符合条件的慢性呼吸衰竭患者行无痛纤支镜技术安全性是值得肯定的。
Objective To explore and evaluate the application and safety of painless bronchoscopy in patients with chronic respiratory failure. Methods Sixty patients with COPD were enrolled in this study. The partial pressure of arterial oxygen was less than 60 mmHg and the partial pressure of arterial carbon dioxide was more than 50 mmHg. The degree of oxygen saturation or non-oxygen saturation was over 90%. Fiberoptic bronchoscopy Bronchoscopic interventional examination of patients, the implementation of painless bronchoscopy or bronchoscopic interventional therapy, recording before and after its oxygen saturation, heart rate, blood pressure changes, tolerance time, the completion of the observation. Results All 60 patients had respiratory failure before surgery, of which 50 patients had oxygen saturation less than 90% (1 patient was as low as 83%, 85% others were between 86% and 89%), and 25 patients Can reach 90%. 50 cases were able to tolerate surgery, two cases of oxygen saturation decreased to 40% after not resumed by simple ventilator-assisted breathing 5 minutes later rose to 90%, 9 cases of oxygen saturation decreased to 60% to 80% High jaw, smooth the respiratory tract, increase oxygen concentration, 5 ~ 20 min recovery of more than 90%. Conclusions The safety of painless fiberoptic bronchoscopy in eligible patients with chronic respiratory failure is worthy of recognition.