目的 探讨纤维支气管镜在神经外科重症病人气道管理中的应用价值.方法 我院神经外科与呼吸内科、ICU科合作,对我院开放气道的206例神经外科重症病人进行纤维支气管镜检查和治疗,并对其痰标本阳性率、血气分析指标的变化以及胸片的变化进行前后自身对照.结果 经纤支镜留取的痰标本的痰培养阳性率明显高于常规途径留取的痰标本培养,治疗前后血气分析中pH、PaO2、PaCO2、SaO2等各项指标以及胸片检查均明显好转(P＜0.05);引导经鼻气管插管,调整及更换气管切开套管成功率明显提高.结论 纤维支气管镜的检查和治疗在神经外科重症病人气道管理中有重要价值.%Objective To analyze the application value of fiberoptic bronchoscope in airway management in neurosurgical severe patient. Methods The positive rate of sputum, values of blood gas analysis and chest radiograph were measured before and after fiberoptic bronehoscope manipulation in 206 cases of open-airway neurosurgical severe patients. Results The positive rate of sputum cultured that get by fiberoptic bronchoscope is obviously superior to that by routine way. The indexes of blood gas analysis such as PH, PaO2,PaCO2,SaO2 and the chest films were evidently improved after treatment (P< 0.05). Also the success rate of guiding tracheal intubation by nose and adjusting or changing tracheostomy cannula were increased. Conclusion The examination and treatment by fiberopfic bronehoseope played an important role in the airway management of neurosurgical severe patients.
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