围术期护理干预在纤维支气管镜治疗COPD患者中的应用价值  

Application and nursing observation of fiber bronchoscopy in chronic obstructive pulmonary disease

作　　者：任婧[1] 孙琳[2] 李芸[1] 

机构地区：[1]四川大学华西医院全科医学科,四川成都610041 [2]四川大学华西医院呼吸内科,四川成都610041

出　　处：《西部医学》2016年第4期567-569,573,共4页Medical Journal of West China

基　　金：四川省科技计划项目(2013SZ0001)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者应用纤维支气管镜进行吸痰和肺泡灌洗的效果及围术期护理干预价值。方法选取62例进行治疗的COPD患者作为研究对象,在常规综合治疗的基础上联合纤维支气管镜进行吸痰和肺泡灌洗。治疗过程中进行围术期的护理干预,并对干预前后患者血气、肺功能的变化进行统计分析。结果术后共发生8例并发症,并发症发生率为12.9%,其中以咳血、发热居多。治疗后患者的PaO2、PaCO2、SPO2、WBC血气指标较治疗前改善明显,差异具有统计学意义(P<0.05)。治疗前患者VC、FEV1及6MWD分别为(2.48±0.32)L、(1.49±0.27)L、(125.2±16.83)m,而治疗后则分别为(2.93±0.26)L、(2.01±0.13)L、(187.83±24.28)m,治疗前后比较,患者的VC、FEV1及6MWD都显著增加(P<0.05)。结论纤维支气管镜在COPD患者的治疗中具有重要的作用,通过吸痰和肺泡灌洗能及时清除气道内的分泌物,改善患者肺部通气,提高微生物培养和药敏试验的准确性。围术期护理对COPD患者诊疗有重要的临床意义。Objective To observe the effect and nursing intervention value of the patients with chronic obstructive pulmonary disease（COPD）by using the fiber bronchoscopy.Methods 62 patients with COPD were selected as the research object.The patients were treated with the conventional treatment and nursing intervention during perioperative period.Results Postoperative complications occurred in 8patients and the complication rate was 12.9%.The hemoptysis,fever,PaO2,SPO2,PaCO2 and WBC and blood gas indexes of the patients after treatment were significantly improved compared with those before treatment（P〈0.05）.VC,FEV1 and 6 MWDS before treatment were 2.48 ±0.32 L,1.49±0.27 Land 125.2±16.83 m,respectively.while they after treatment were 2.93± 0.26 L,2.01±0.13 L and 187.83±24.28 m,respectively.6MWD,FEV1 and VC were significantly increased after treatment（P〈0.05）.Conclusion Fiber bronchoscopy has important function in treatment of chronic obstructive pulmonary disease,which can remove the secretion of airway,improve the accuracy of microbial culture and drug sensitivity test.At the same time,it is an important guarantee for the successful completion of the diagnosis and treatment.

关 键 词：纤维支气管镜 COPD 肺泡灌洗 围术期护理干预 

分 类 号：R563[医药卫生—呼吸系统]