纤维支气管镜支气管肺泡灌洗治疗机械通气并发肺部感染疗效观察  

Effect of bronchofibroscope bronchoalveolar lavage in the treatment of pulmonary infection induced by mechanical ventilation

作　　者：吴雪花[1] 王昌锋[2] 杨亚东[1] 

机构地区：[1]黄冈市中心医院重症医学科,湖北黄冈438000 [2]黄冈市中心医院呼吸内科,湖北黄冈438000

出　　处：《新乡医学院学报》2017年第7期596-598,603,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨纤维支气管镜支气管肺泡灌洗治疗机械通气并发肺部感染患者的临床效果。方法选取2015年6月至2016年6月黄冈市中心医院收治的机械通气并发肺部感染患者120例,根据治疗方法将患者分为观察组和对照组,每组60例。对照组患者给予常规治疗,观察组患者在常规治疗基础上给予纤维支气管镜支气管肺泡灌洗。对2组患者治疗前后动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、动脉血氧饱和度(SaO_2)及血清C反应蛋白(CRP)、降钙素原(PCT)水平进行比较,并对2组患者疗效、机械通气时间、抗生素使用时间、症状改善时间、住院时间进行比较。结果治疗前2组患者PaO_2、PaCO_2、SaO_2及血清CRP、PCT水平比较差异均无统计学意义(P>0.05);治疗7 d后,2组患者PaO_2、SaO_2显著升高(P<0.05),PaCO_2及血清CRP、PCT水平显著降低(P<0.05);且观察组患者PaO_2、SaO_2显著高于对照组(P<0.05),PaCO_2及血清CRP、PCT水平显著低于对照组(P<0.05)。观察组患者机械通气时间、抗生素使用时间、呼吸衰竭纠正时间、咳嗽咳痰消失时间、肺部炎症吸收时间及住院时间均显著短于对照组(P<0.05)。观察组和对照组患者治疗总有效率分别为93.33%(56/60)、78.33%(47/60),观察组患者治疗总有效率显著高于对照组(χ~2=5.551 1,P<0.05)。结论纤维支气管镜支气管肺泡灌洗可显著改善机械通气并发肺部感染患者的临床症状和肺功能,减轻炎症反应,缩短治疗时间和住院时间。Objective To investigate the clinical effect of bronchoalveolar lavage in the treatment of pulmonary infection induced by mechanical ventilation. Methods A total of 120 patients with pulmonary infection induced by mechanical ventilation were selected from June 2015 to June 2016 in Huanggang Central Hospital. The patients were divided into observation group and control group according to the treatment methods,60 cases in each group. The patients in the control group were treated with conventional treatment measures,and the patients in the observation group were treated with bronchoalveolar lavage by bronchofibroscope on the basis of routine treatment. The arterial oxygen partial pressure（ PaO2）,arterial carbon dioxide partial pressure（ PaCO2）,arterial oxygen saturation（ SaO2） and the levels of serum C reactive protein（ CRP）,procalcitonin（ PCT） were compared between the two groups before and after treatment. The curative effect,mechanical ventilation time,antibiotic use time,symptom improvement time and hospitalization time were compared between the two groups. Results There was no significant difference in the PaO2,PaCO2,SaO2 and the levels of serum CRP,PCT between the two groups before treatment（ P〈0. 05）. After treatment for seven days,the PaO2 and SaO2 increased significantly（ P〈0. 05）; the PaCO2 and serum CRP,PCT levels decreased significantly in the two groups（ P〈0. 05）; the PaO2 and SaO2 in the observation group were significantly higher than those in the control group（ P〈0. 05）; and the levels of PaCO2,serum CRP and PCT were significantly lower than those in the control group（ P〈0. 05）. The mechanical ventilation time,antibiotics use time,respiratory failure correction time,cough and expectoration disappearance time,lung inflammation absorption time and hospitalization time in the observation group were significantly shorter than those in the control group（ P〈0. 05）. The total effective rate in the observation group and control group was 93. 33%（ 56/

关 键 词：机械通气 肺部感染 纤维支气管镜 支气管肺泡灌洗 肺功能 降钙素原 

分 类 号：R563[医药卫生—呼吸系统]