早期气道开放联合肺泡灌洗术救治重型颅脑损伤致吸入性肺炎的临床研究  

The clinical application of early opened artificial airway combined with bronchoalveolar lavage on patients with aspirated pneumonia after severe brain injury

作　　者：陈志斌[1] 陈艺坛[2] 潘云虎[2] 林庆喜[1] 林承怀[1] 

机构地区：[1]解放军第92医院神经外科,福建南平353000 [2]解放军第92医院呼吸内科,福建南平353000

出　　处：《临床军医杂志》2012年第2期260-262,共3页Clinical Journal of Medical Officers

摘　　要：目的研究早期气道开放联合纤维支气管镜肺泡灌洗术救治重型颅脑损伤致吸入性肺炎患者的价值及安全性。方法将入选患者,随机分治疗组与对照组。(1)治疗组患者观察其灌洗术前后的心率(HR)、血氧饱和度(SpO2)、动脉氧分压(PaO2)、二氧化碳分压(PaCO2)变化。(2)治疗组与对照组治疗结束后进行疗效分析,包括:机械通气时间、发热、咳嗽、咳痰持续时间、肺部啰音消失时间、使用抗生素时间等方面对比分析,并对治愈率、死亡率进行比较。结果治疗组42例,术程顺利,无并发症,术后HR、SpO2、PaO2明显好转(P<0.05),机械通气时间、发热、咳嗽、咳痰持续时间及肺部啰音消失时间明显缩短,治疗组与对照组的机械通气时间、肺部啰音消失时间、治愈率、死亡率比较,差异有统计学意义(P<0.05)。结论早期气道开放联合纤维支气管镜肺泡灌洗术救治重型颅脑损伤并发吸入性肺炎患者,治疗效果好,安全性高。Objective To investigate the value and safety of early opened artificial airway combined with bronchoalveolar lavage by way of fibrobronchoscopy on patients with aspirated pneumonia after severe brain injury.Methods The selected patients were randomly divided into treatment group and control group.（1）We observed the heart rate（HR）,oxygen saturation（Sp02）,arterial partial pressure of oxygen（PaO2）and changes in carbon dioxide partial pressure PaCO2 of patient with the bronchoalveolar lavage in pre and post therapy.（2）We analyzed the curative effect of two groups that including the mechanical ventilation time,the average time of fever,cough,expectoration,pulmonary rale disappearance and antibiotics time,and the cure rate,mortality in the end of treatment.Results There were no complications in 42 patients of treatment group.The HR,SpO2 and PaO2 of patients improved significantly in post-treatment（P〈0.05）.The patients’mechanical ventilation time,average time of fever,cough,expectoration and pulmonary rale disappearance time were significantly shorter after therapy.Compared the mechanical ventilation and pulmonary rale disappearance time of patients,cure and mortality rate between the two groups,the difference showed statistical significance（P〈0.05）.Conclusion The early opened artificial airway combined with bronchoalveolar lavage by way of fibrobronchoscopy on patients with aspirated pneumonia after severe brain injury is effective and safety.

关 键 词：支气管肺泡灌洗术 早期气道开放 重型颅脑损伤 吸入性肺炎 

分 类 号：R651.15[医药卫生—外科学]