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目的探讨三通喉罩通气下纤维支气管镜(纤支镜)对重症肺炎患者的治疗作用及安全性。方法 30例重症肺炎患者(治疗组)在快速诱导麻醉下插入三通喉罩,其标准端口连接呼吸机,另一带有密封胶帽端口置入纤支镜,实施支气管肺泡灌洗术。另选取30例重症肺炎患者作为对照组,表麻下经纤支镜常规行支气管肺泡灌洗术。观察两组术前、术中、术后心率、血压、脉搏氧饱和度的变化,并观察术后疾病的转归情况。结果治疗组全部30例手术顺利完成,三通喉罩通气不同时间点血流动力学指标稳定,通气效果良好,无明显并发症;术中治疗组心率、血压显著低于对照组(P<0.01),脉搏氧饱和度显著高于对照组(P<0.01)。总有效率治疗组(93.3%)明显优于对照组(76.7%)(P<0.05)。结论三通喉罩通气下经纤支镜治疗重症肺炎相对于常规纤支镜治疗,具有安全、可靠、并发症少、效果满意等优点。
Objective To investigate the therapeutic effect and safety of bronchofiberscope (bronchofiberscope) under the treatment of three-way laryngeal mask ventilation in patients with severe pneumonia. Methods Thirty patients with severe pneumonia (treatment group) underwent rapid induction anesthesia with a three-way laryngeal mask. The standard port was connected to the ventilator and the other was equipped with sealant cap port for bronchial alveolar lavage. Another 30 patients with severe pneumonia were selected as the control group, the table under the general bronchofibroscopy bronchial alveolar lavage. The changes of heart rate, blood pressure and pulse oxygen saturation of the two groups before and after surgery were observed and the prognosis of postoperative disease was observed. Results All the 30 cases in the treatment group were successfully completed. The hemodynamic indexes of the three-way laryngeal mask ventilation were stable at different time points, and the ventilation effect was good with no obvious complications. The heart rate and blood pressure in the treatment group were significantly lower than those in the control group (P <0.01) ), Pulse oxygen saturation was significantly higher than the control group (P <0.01). The total effective treatment group (93.3%) was significantly better than the control group (76.7%) (P <0.05). Conclusion Three-way laryngeal mask ventilation in the treatment of severe pneumonia by bronchofibers compared with conventional bronchoscopy treatment, with safety, reliability, fewer complications, the effect is satisfactory and so on.