呼吸器内科でのシングルユースビデオ気管支鏡の使用経験  [in Japanese] Experience with a Single-Use Bronchoscope in the Respiratory Medicine Department  [in Japanese]

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Author(s)

    • 當銘 玲央 Tome Reo
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科)|沖縄赤十字病院呼吸器内科 Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus|Department of Respiratory Medicine, Okinawa Red Cross Hospital
    • 宮城 一也 Miyagi Kazuya
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • 喜友名 朋 Kiyuna Tomo
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • Gretchen Parrott
    • Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • 金城 武士 Kinjo Takeshi
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • 原永 修作 Haranaga Shusaku
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • 健山 正男 Tateyama Masao
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
    • 藤田 次郎 Fujita Jiro
    • 琉球大学大学院医学研究科感染症・呼吸器・消化器内科学(第一内科) Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus

Abstract

<p><b>背景.</b>シングルユース(単回使用)の気管支鏡はその特性から集中治療室や救急部での使用経験が報告されているが,呼吸器内科での使用経験の報告は少ない.当院でシングルユースビデオ気管支鏡を使用した症例について報告する.<b>症例.</b>2016年4月から2017年3月の間に,11例延べ14件に対しシングルユースビデオ気管支鏡が使用された.代表的な2例を示す.症例7は77歳男性.右膿胸の治療中に喀血にて挿管となった.シングルユースビデオ気管支鏡を用いて血餅除去を行ったが気管粘膜と血塊の判別が難しく,通常の気管支鏡へ変更とした.症例9は63歳男性.両側誤嚥性肺炎,左膿胸の診断で入院となった.左右主気管支内に多量の喀痰が貯留するため数日おきに吸痰を行ったが,時間外はシングルユースビデオ気管支鏡を使用した.上記2例を含め,14件中7件は緊急または時間外使用であった.<b>結論.</b>シングルユースビデオ気管支鏡は通常の気管支鏡に取って代わるものではないが,軽量で設定も簡便なため特に緊急時に有用であった.また,気管支鏡の損傷を気にせず手技を行うことができ,交差感染が起きないことも利点である.</p>

<p><b><i>Background.</i></b> Single-use bronchoscopes have been used primarily in intensive-care units and emergency departments. However, information regarding single-use bronchoscopes in the respiratory medicine departments is limited. We reported on the outcomes of patients who underwent single-use bronchoscopy at our department. <b><i>Cases.</i></b> From April 2016 to March 2017, a single-use bronchoscope was used in 14 cases (11 patients). Two representative cases are reported here. Case 7: A 77-year-old man was intubated with hemoptysis during treatment of empyema. We performed single-use bronchoscopy to remove an endobronchial blood clot. However, this approach was switched to regular bronchoscopy because of ambiguous findings suggesting both blood clots and bronchial mucosa. Case 9: A 63-year-old man was admitted to our hospital due to bilateral aspiration pneumonia and left empyema. Since a large amount of sputum was found stored in both bronchi, we performed bronchoscopy to remove sputum every few days. A single-use video bronchoscope was selected for use in the off-hours. Including the above two cases, single-use bronchoscopy was performed in an emergency situation or off-hours in 7 out of 14 cases. <b><i>Conclusion.</i></b> Although single-use bronchoscopes do not supersede the utility of traditional bronchoscopes, they are useful in their own way, especially in emergency situations and during off-hours, as they are light-weight, quick to set up, and easy to use. In addition, since they are single-use, there is no need to consider the need for repairs or risk of cross-contamination.</p>

Journal

  • The Journal of the Japan Society for Respiratory Endoscopy

    The Journal of the Japan Society for Respiratory Endoscopy 41(4), 411-416, 2019

    The Japan Society for Respiratory Endoscopy

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