纤维支气管镜在ICU并发肺部感染中的临床应用价值  

Clinical application value of fiber bronchoscopy in ICU complicated with pulmonary infection

作　　者：莫俊德[1] 林萍[1] 张日霖[1] 陈莲芳[1] 钟国荣[1] MO Jun-de LIN Ping ZHANG Ri-lin CHEN Lian-fang ZHONG Cuo-rong(Intensive Care Unit,Central People＇s Hospital of Zhanjiang City in Guangdong Province,Zhanjiang 524037,Chin)

机构地区：[1]广东省湛江中心人民医院重症医学科,广东湛江524037

出　　处：《中国当代医药》2016年第36期27-29,共3页China Modern Medicine

摘　　要：目的 探讨纤维支气管镜在重症医学科（ICU）并发肺部感染中的临床应用价值。方法 选择2014年2月~2016年7月我院收治的96例ICU并发肺部感染患者,随机分为对照组和观察组,每组各48例,对照组给予常规肺部抗感染治疗,观察组在此基础上给予纤维支气管镜肺泡灌洗吸痰术治疗,比较两组临床疗效、治疗前后血清炎性应激指标和动脉血气指标变化。结果 与对照组相比,观察组患者咳嗽明显减少时间、肺部啰音明显减少时间显著减短,差异有统计学意义（P〈0.05）。观察组临床疗效总有效率（95.83%）显著高于对照组（83.33%）,差异有统计学意义（P〈0.05）。治疗24、72 h后与对照组相比,观察组PCT及hs-CRP水平均显著低于对照组,差异有统计学意义（P〈0.05）。治疗后与对照组相比,观察组Pa O2、Sa O2、Fa O2/Fi O2（氧合指数）显著高于对照组,Pa CO2水平显著低于对照组,差异均有统计学意义（P〈0.05）。结论 纤维支气管镜肺泡灌洗吸痰术治疗ICU并发肺部感染可有效提高患者临床效果,改善重症肺部感染患者的呼吸状态与炎性应激程度,值得临床应用推广。Objective To investigate the clinical value of bronchoseopy in intensive care unit （ICU） complicated with pulmonary infection.Methods 96 cases of ICU patients complicated with pulmonary infection in our hospital from February 2014 to July 2016 were randomly divided into control group and observation group,48 cases in each group.Pa- tients in the control group was given routine pulmonary anti infection treatment,while patients in the observation group received bronchoalveolar lavage and sputum aspiration treatment,cllnical curative effect and serum inflammatory stress index and arterial blood gas changes before and after treatment in two groups were compared.Results Compared with control group,cough disappearance time,pulmonary rales disappeared time in the observation group was significantly shortened,and the difference was statistically significant （P〈0.05）;clinieal curative effect of observation group total effec- tive rate （95.83%） was significantly higher than that of the control group （83.33%）,and the difference was statistically significant（P〈O.O5）;for the treatment of 24,72 h compared with the control group,the changes of PCT,hs-CRP in the ob- servation group： was sign：ifieantly, lower than that in the control group,and, the difference was statistically significant （P〈 0.05）.PaO2 and SaO2,FaO2/FiO2 in the observation group was significantly higher than that in the control group,level of PaCO2 was significantly lower than that in the control group,and the differences were statistically significant （P〈0.05）. Conclusion Bronchoalveolar lavage and sputum aspiration in the treatment of ICU complicated with pulmonary infec- tion can effectively improve clinical efficacy,improve respiratory, status and inflammatory stress levels in patients with severe pulmonary infection,it is worthy of clinical application.

关 键 词：纤维支气管镜 ICU 肺部感染 

分 类 号：R563[医药卫生—呼吸系统]