【摘要】 目的:观察纤维支气管镜 (纤支镜 )直视下清除机械通气支持患者的气管套管气囊上方积存物的有效性和安全性。方法:对37例合并重度昏迷、咳嗽反射消失的患者 ,在机械通气状态下 ,将纤支镜经气管套管与呼吸机相连的三通进入气管腔 ,开放气囊后 ,当气囊上方的积存物向下流至纤支镜的可见范围时 ,直视下吸除。气囊充气后 ,纤支镜原位停留1min左右 ,以吸除随着气囊充气而向下流出的积存物。根据患者情况每24h操作1～2次。结果:37例以本方法清除气囊上积存物3～139d共操作597次 ;每次5～10min ,吸出量在14～53mL/次 ,每次气囊充气后均可见2mL左右的积存物流出并吸除。SpO2 降低>0 04(较操作前 )152例次 (25 5% ) ,心率增快>10次/min311例次 (52 4% ) ,心率低于60次/min9例次 (3 2 % ) ,呕吐3次 (0 5 % ) ,气管黏膜损伤、少量出血11例次 (1 8 % )。结论:该法是一种安全、有效的清除气囊上积存物的方法更多还原

【Abstract】 Objective:To evaluate the efficacy and safety of the suction of the deposits in the endotracheal intubation with bronchofiberscope.Methods:The bronchofiberscope came to the tracheal lumen via three passway tube under the condition of the mechanical ventilation.The deposits above the air pocket were absorbed with bronchofiberscope when they flew to the visible field.Thirty_seven patients with serious coma and without cough reflection received the treatment.This manipulation was repeated 1 to 2 times in every 24 hours according to the patients’ status.Results:Thirty_seven patients received 597 times of operations with 5～10 minutes each time in 3～139 days,and the volume of the suction was 14～53 ml each time,and about 2 ml deposits were drained after every inflation.Decreased SpO2>4% compared with the pre operation was 25.5%,increased heart rate>10/min was 52.4%,heart rate<60/min was 3.2%,vomiting was 0.5%,and damaged broncho villi and bleeding was 1.8%.Conclusion:It’s a safe and effective method to drain the deposits of the slime.更多还原