纤维支气管镜肺灌洗对机械通气患者肺部感染的疗效研究  

Clinical effect of bronchoscope lung lavage on treatment of mechanical ventilation patients with pulmonary infections

作　　者：陈刚[1] 徐长青[1] 黄旭晴[1] 徐永芳[1] 王斌[2] 

机构地区：[1]杭州师范大学附属医院呼吸科,浙江杭州310005 [2]杭州师范大学附属医院ICU,浙江杭州310005

出　　处：《中华医院感染学杂志》2016年第2期312-313,328,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药科技基金资助项目(201466009)

摘　　要：目的分析纤维支气管镜肺灌洗应用于机械通气发生肺部感染患者的临床疗效。方法选择2012年1月-2014年12月医院ICU住院的机械通气合并肺部感染的患者90例,根据患者入住ICU时间顺序分为研究组与对照组,各45例,研究组给予纤维支气管镜肺灌洗治疗,对照组给予常规的吸痰治疗,对比两组患者在治疗前感染程度及治疗后7d的临床疗效;采用SPSS18.0对数据进行统计分析。结果患者治疗后总有效率研究组为93.33%,对照组为82.22%,研究组总有效率显著升高,差异有统计学意义(P<0.05);治疗前两组患者感染程度对比差异无统计学意义,治疗后7d研究组患者感染程度显著改善,与对照组对比差异有统计学意义(P<0.05);研究组患者在纤维支气管镜肺灌洗后1h的PaO_2、PaCO_2、SaO_2显著改善,差异有统计学意义(P<0.05)。结论纤维支气管镜肺灌洗应用于机械通气发生肺部感染患者的治疗安全有效,并能显著改善患者的动脉血气。OBJECTIVE To observe the clinical effect of bronchoscope lung lavage on treatment of the mechanical ventilation patients with pulmonary infections.METHODS A total of 90 mechanical ventilation patients complicated with pulmonary infections who were hospitalized the ICU from Jan 2012 to Dec 2014 were enrolled in the study and divided into the study group and the control group according to the time sequence of admission to the ICU,with 45 cases in each.The study group was treated with bronchoscope lung lavage,and the control group was given the conventional sputum suction.The severity of infections before the treatment and the clinical effect after the treatment for 7days were observed and compared between the two groups of patients.RESULTS The total effective rate of treatment of the study group was 93.33%,significantly higher than 82.22% of the control group,and there was significant difference（P〈0.05）.There was no significant difference in the severity of infections between the two groups of patients before the treatment,while there was significant difference in the severity of infections between the study group and the control group after the treatment for 7days（P〈0.05）.The PaO2,PaCO2,and SaO2 of the study group were significantly improved after the bronchoscope lung lavage for 1hour,with statistical significance（P〈0.05）.CONCLUSIONThe bronchoscope lung lavage is safe and effective in the treatment of the mechanical ventilation patients complicated with pulmonary infections,and it can significantly improve the arterial blood gas of the patients.

关 键 词：机械通气 肺部感染 纤维支气管镜 临床疗效 

分 类 号：R563.1[医药卫生—呼吸系统]