两种术前出血部位定位方法在大咯血急症手术中的应用

摘要

目的 比较大咯血急症手术中两种术前出血部位定位方法,评价其临床实用价值.方法 患者在全麻下行Carlens双腔管气管插管后:对照组用吸痰管间断多次吸引左右主支气管血液,观察两侧吸引血液的量来判断患者的出血部位;研究组用纤维支气管镜分别对两侧肺进行吸引检查确定出血部位.对两种出血部位定位所需时间,进行比较;对术后患者治疗情况进行随访分析.结果 纤支镜比吸痰管术前确定出血部位所需时间明显缩短,术后无再咯血发生.结论 大咯血急症手术中,术前出血部位的定位吸痰管吸引法既简单又经济实用,可推广应用.%Objective To compare two ways of defining hemorrhagic sites with massive hemoptysis operation and evaluate their clinical application. Methods Patients intubated with a carlens double-lumen endobronchial tube (DLT) under general anesthetic were observed during surgery. In the compared group, suction catheter was used continually on right and left main bronchus, and hemorrhagic sites were defined through observing the blood volume; while in the researched group, fibrobranchoscope was used on lungs to define the hemorrhagic sites. The required time and the treatment effects of two groups were compared. Results It took much less time using fibrobranchoscope, and no hemoptysis occurred after operation. Conclusion During massive hemoptysis operation, it is economical and practical to use suction catheter to define the hemorrhagic sites, which can be spread among grassroots hospitals; while it is quick and accurate to use fibrobranchoscope, which improves the success rate in rescuing critically ill patients and can be spread among hospitals where conditions permit.