纤维支气管镜治疗老年人呼吸机相关性肺炎的疗效探讨  

Clinical application and significance of fiberoptic bronchoscopy in elderly patients with ventilator-associated pneumonia

作　　者：石小伟[1] 胡洁[1] 李赛男[1] 韦丽娜[1] 

机构地区：[1]首都医科大学附属北京天坛医院呼吸内科,北京市100050

出　　处：《实用老年医学》2017年第4期338-340,共3页Practical Geriatrics

基　　金：北京医学卫生科技联合攻关项目基金(200210246)

摘　　要：目的探讨纤维支气管镜吸痰对老年呼吸机相关性肺炎(VAP)病人的应用效果。方法将2013年5月至2016年5月期间进行气管插管或切开实施机械通气后发生VAP的老年病人112例随机分成观察组与对照组,观察组使用纤维支气管镜吸痰治疗,对照组进行常规治疗,比较2组的临床肺部感染评分(CPIS)、机械通气时间、VAP治愈时间以及住院时间、KPS评分等。结果治疗后第3天和第5天,观察组的CPIS评分明显低于对照组,差异具有统计学意义(P<0.05);观察组的机械通气时间、VAP治愈时间以及住院时间明显短于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜治疗老年VAP能够有效降低感染,加快病情恢复,提高日常活动能力。Objective To study the effect of fiberoptic bronchoscopy in elderly patients with ventilator-associated pneumonia（VAP）. Methods From May 2013 to May 2016, 112 patients with VAP who conducted mechanical ventilation after endotracheal intubation or incision were randomly divided into two groups. The observation group was treated with fiberopticbronchoscopy treatment and the control group received conventional treatment. The clinical pulmonary infection score （CPIS） , length of mechanical ventilation, VAP healing, hospital stay, and the KPS score were observed and compared. Results On the third and fifth day after treatment, CPIS in observation group was significantly lower than that in control group （P〈0. 05）.The length of mechanical ventilation, VAP healing and hospital stay in the observation group were significantly shorter than those in control group （P〈0. 05）. Conclusions Fiberoptic bronchoscopy can effectively reduce degree of infection, accelerate the recovery, and improve activities of daily living for elderly patients with VAP.

关 键 词：呼吸机相关性肺炎 纤维支气管镜 老年人 

分 类 号：R563.1[医药卫生—呼吸系统] R454.9[医药卫生—内科学]