床旁支气管镜灌洗对急性缺血性脑卒中后急性肺损伤的影响  

Effect of bedside bronchoscopy lavage on acute lung injury after acute ischemic stroke

作　　者：童岳阳[1] 冯哲敏[1] 黄旭晴[1] 陈学远[1] 何文波[1] 李雅倩 TONG Yueyang;FENG Zhemin;HUANG Xuqing;CHEN Xueyuan;HE Wenbo;LI Yaqian(Department of Respiratory Medicine,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院呼吸内科

出　　处：《中国现代医生》2019年第33期46-49,共4页China Modern Doctor

基　　金：浙江省公益性技术应用研究计划项目(2015C33258)

摘　　要：目的观察床旁支气管镜灌洗治疗对急性缺血性脑卒中(AICS)并发急性肺损伤(ALI)的临床疗效。方法收集我科2016年1月~2018年12月收治的AICS并发肺部疾病患者,ALI患者在常规治疗基础上接受支气管镜灌洗,非ALI患者接受常规治疗;分析支气管镜灌洗对ALI患者肺功能及临床过程的影响。结果两组间退热时间、机械通气时间比较差异无统计学意义(P>0.05);ALI组ARDS发病率高于非ALI组,差异有统计学意义(P<0.05);ALI组肺功能改善明显,入组时低于非ALI组(P<0.05),灌洗治疗后两组肺功能基本接近(P>0.05)。结论支气管镜灌洗可以显著改善ALI患者的肺功能,降低病死率,但不能降低ARDS的发病率。Objective To observe the clinical efficacy of bedside bronchoscopy lavage on the treatment of acute ischemic stroke(AICS)complicated with acute lung injury(ALI).Methods Patients with AICS complicated with pulmonary disease admitted to our department from January 2016 to December 2018 were enrolled.Patients with ALI underwent bronchoscopy based on conventional treatment,and non-ALI patients received routine treatment.The effect of bronchoscopy lavage on lung function and clinical course in patients with ALI was analyzed.Results There was no significant difference in antipyretic time and mechanical ventilation time between the two groups(P>0.05).The incidence of ARDS in the ALI group were higher than that in the non-ALI group(P=0.000).Pulmonary function was significantly improved in the ALI group,which was lower than that in the non-ALI group(P<0.05).The lung function of the two groups was similar after lavage treatment(P>0.05).Conclusion Bronchoscopy lavage can significantly improve lung function and reduce mortality in ALI patients,but it can not reduce the incidence of ARDS.

关 键 词：急性肺损伤 支气管镜 脑卒中 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R563.8[医药卫生—临床医学]