强化排痰方案辅助BAL对行机械通气重症肺炎患者呼吸功能、生命体征及死亡率的影响  

Influence of intensive sputum elimination program assisted with BAL on respiratory function,vital signs and mortality of severe pneumonia patients undergoing mechanical ventilation

作　　者：刘宽[1] 杨叶叶 张春萍[1] 孙帅森 陈正贤[2] LIU Kuan;YANG Ye-ye;ZHANG Chun-ping;SUN Shuai-sen;CHEN Zheng-xian(Department of Respiration,the Central Hospital of Sanmenxia City,Sanmenxia,Henan 472000,Chin)

机构地区：[1]三门峡市中心医院呼吸科,河南三门峡472000 [2]中山大学第六附属医院,广东广州510655

出　　处：《临床肺科杂志》2018年第9期1683-1686,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨强化排痰方案辅助BAL对行机械通气重症肺炎患者呼吸功能、生命体征及死亡率的影响。方法选取我院2015年8月-2017年8月收治行机械通气重症肺炎患者共110例,以随机数字表法分为对照组(55例)和观察组(55例),分别给予BAL单用和在此基础上加用强化排痰方案治疗;比较两组患者临床疗效、治疗前后呼吸功能指标水平、生命体征指标水平、机械通气时间、ICU住院时间及随访28d死亡率。结果观察组患者治疗总有效率显著高于对照组(P<0.05);观察组患者治疗后Pa O_2/Fi O_2、Cdyn及WOB水平均显著优于对照组、治疗前(P<0.05);两组患者治疗前后生命体征指标水平比较差异无统计学意义(P>0.05);观察组患者机械通气时间和ICU住院时间均显著短于对照组(P<0.05);两组患者随访28d死亡率比较差异无统计学意义(P>0.05)。结论强化排痰方案辅助BAL治疗行机械通气重症肺炎可有效控制感染症状,改善呼吸功能,加快病情康复进程,且未影响生命体征。Objective To investigate the influence of intensive sputum elimination program assisted with BAL on respiratory function,vital signs and mortality of severe pneumonia patients undergoing mechanical ventilation. Methods 110 severe pneumonia patients undergoing mechanical ventilation were chosen from August 2015 to August 2017 and random Ly divided into two groups,including the control group（ 55 patients） with BAL used alone and the observation group（ 55 patients） with intensive sputum elimination program on the basis of the control group.The clinical effect,the levels of respiratory function and vital signs were analyzed before and after treatment,and the mechanical ventilation time,the duration of ICU stay and the mortality in 28 d follow-up were compared between the two groups. Results The clinical effect of the observation group were significant better than that of the control group（ P〈0. 05）. The levels of Pa O_2/Fi O_2,Cdyn and WOB in the observation group after treatment were significant better than those in the control group and before treatment（ P〈0. 05）. There was no significant difference in the levels of vital signs before and after treatment between the 2 groups（ P〈0. 05）. The mechanical ventilation time and the duration of ICU stay in the observation group were significant better than that in the control group（ P〈0. 05）. There was no significant difference in the mortality of 28 d follow-up（ P〈0. 05）. Conclusion Intensive sputum elimination program assisted with BAL can efficiently control the infection symptoms,improve respiratory function,speed up the rehabilitation process and not affect vital signs in the treatment of severe pneumonia patients undergoing mechanical ventilation.

关 键 词：排痰 BAL 机械通气 重症肺炎 疗效 安全性 

分 类 号：R563.1[医药卫生—呼吸系统]