提出了一种新的止血方法,用于气管和支气管的糜烂出血并发症

Gavhar Mahmudkhanovna AZIZOVA, Sardor Khamdamovich IBRAGIMOV, Anvarbek Shamkhatovich ARIFJANOV, Ravshan Aliyevich IBADOV
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引用次数: 0

摘要

呼吸机相关并发症是最常见的阻碍重症监护患者康复的并发症。本研究旨在评估内镜治疗呼吸机相关性气管支气管炎患者气管支气管树急性出血性病变的有效性。5例患者(平均年龄22.4±3.3岁,18 ~ 36岁)在复苏加重症监护病房延长机械通气48小时。呼吸机相关性气管支气管炎的诊断建立在临床体征、放射学和微生物学标准的基础上。应用该方法时使用具有止血性能的细分散粉末(HEMOBEN)作为止血剂。一项形态计量学研究指出,呼吸机相关的气管支气管炎伴有气管和支气管粘膜明显的淋巴中性粒细胞浸润(证实有不同程度的弥漫性卡他性炎症和糜烂性变形支气管炎的迹象)。在一个复杂的过程中,伴随着脓性炎症和糜烂性出血成分及其血管化和化生变化以及对上皮内壁完整性的破坏也会导致组织完整性的破坏,由于破坏和坏死。因此,我们开发了一种方法,在粘膜损伤的情况下,局部应用HEMOBEN止血,使我们能够迅速覆盖出血表面,并具有充分的止血效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A proposed new method of hemostasis for erosive-hemorrhagic complications of the trachea and bronchi
Ventilator-associated complications are the most frequent ones that prevent the recovery of intensive care patients. This study aimed to evaluate the effectiveness of the endoscopic treatment of acute hemorrhagic lesions of the tracheobronchial tree in patients with ventilator-associated tracheobronchitis. A total of 5 patients (22.4±3.3 mean age, 18 to 36 years) with prolonged mechanical ventilation (>48 hours) in the resuscitation and intensive care unit were monitored. The diagnosis of ventilator-associated tracheobronchitis was established on the basis of clinical signs, radiological and microbiological criteria. Fine-dispersed powder with hemostatic properties (HEMOBEN) was used as a hemostatic agent when applying the method. A morphometric study noted that ventilator-associated tracheobronchitis is accompanied by a pronounced lymphoid-neutrophilic infiltration of the tracheal and bronchial mucosa (signs of diffuse catarrhal inflammation of varying degrees and erosive deforming endobronchitis are verified), and in a complicated course with the presence of a purulent-inflammatory and erosive-hemorrhagic component with its vascularization and metaplastic changes and violations of the integrity of the epithelial lining also leads to a violation of the integrity of tissues due to destruction and necrosis. Hence, a method has been developed to stop bleeding in case of mucosal damage by local application of HEMOBEN, which allows us to quickly cover the bleeding surface with an adequate hemostatic effect.
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