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[目的]探讨纤维支气管镜(纤支镜)对综合ICU重症患者的应用价值。[方法]回顾总结该院ICU对93例危重患者进行238例次纤支镜操作的经验。[结果]43例重症肺炎患者经纤支镜吸痰、支气管肺泡灌洗等治疗后症状明显改善;18例肺不张患者经纤支镜治疗后全部复张;31例行纤支镜引导下经鼻或口气管插管均一次成功;行纤支镜引导经口插入胃管5例均成功。对人工气道梗阻、气管插管或套管易位、气管插管或套管顶端贴气管壁、咯血患者的诊治也取得了明显效果。另外,还可通过细纤支镜了解气管切开患者气囊上切开伤口内出血及肉芽形成情况及冲洗气囊上潴留物。[结论]纤支镜在综合ICU重症病人抢救及气道管理中有重要价值。
[Objective] To evaluate the value of bronchoscopy (bronchofiberscopy) in the treatment of critically ill patients with ICU. [Methods] The review summarizes the experience of 238 cases of subfiberscopy supported by 93 ICU critically ill patients in this hospital. [Results] The symptoms of 43 patients with severe pneumonia were significantly improved after bronchoscopy, bronchoalveolar lavage and so on. All 18 patients with atelectasis were recovered after bronchofiberscopy and 31 patients under the guidance of fiber bronchoscope Transnasal or oral intubation were a success; line fiberoptic bronchoscopy guided oral insertion of 5 cases were successful. The artificial airway obstruction, endotracheal intubation or casing translocation, endotracheal intubation or tracheal wall, hemoptysis patients also made a clear diagnosis and treatment. In addition, but also through the fine bronchoscopy to understand tracheostomy patients with open wound on the wound bleeding and granulation formation and flushing air bag on the retention material. [Conclusion] Fiberoptic bronchoscopy is of great value in the management of severe ICU patients and airway management.