纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效及感染情况影响  

Effect of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration on the curative effect and infection in patients with severe pneumonia complicated with type II respiratory failure

作　　者：林敬明 陈文丽 郑辉才[1] 曾宗鼎[1] 吴淑华 张璐璐 LIN Jing-ming;CHEN Wen-li;ZHENG Hui-cai;ZENG Zong-ding;WU Shu-hua;ZHANG Lu-lu(Department of Breath Internal Medicine,The Third People忆s Hospital of Hainan,Sanya Hainan 572000;Department of Pharmacy,The Third People’s Hospital of Hainan,Sanya Hainan 572000;Department of Breath Internal Medicine,The Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)

机构地区：[1]海南省第三人民医院呼吸内科,南三亚572000 [2]海南省第三人民医院药学部,海南三亚572000 [3]承德医学院附属医院呼吸内科,河北承德067000

出　　处：《蚌埠医学院学报》2020年第1期31-34,共4页Journal of Bengbu Medical College

基　　金：河北省卫计委科技支撑项目(20181157)。

摘　　要：目的:研究纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效及感染情况影响。方法:选取重症肺炎并发Ⅱ型呼吸衰竭病人146例,按照入院编号随机分为联合治疗组与常规治疗组,各73例。常规治疗组病人接受常规抗感染及纠正呼吸衰竭治疗,联合治疗组病人在常规治疗组基础上接受纤维支气管镜吸痰灌洗联合振动排痰治疗。比较2组病人治疗总有效率、发热时间、机械通气时间、住院时间、抗生素使用情况及治疗前后的肺部感染情况。结果:联合治疗组治疗总有效率为93.15%,明显高于常规治疗组的78.08%(P<0.01)。联合治疗组病人发热时间、机械通气时间和住院时间均明显低于常规治疗组(P<0.01)。联合治疗组三联抗生素使用比例为8.22%,明显低于常规治疗组的45.21%(P<0.01)。治疗前2组病人临床肺部感染评分(CPIS)差异无统计学意义(P>0.05));治疗5 d、14 d时,联合治疗组CPIS评分明显低于常规治疗组(P<0.01)。结论:纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效显著,明显缩短病程,有效控制感染,减少抗生素,值得在临床推广。Objective:To study the effects of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration on the curative effect and infection of patients with severe pneumonia complicated with type II respiratory failure.Methods:A total of 146 patients with severe pneumonia complicated with typeⅡrespiratory failure were randomly divided into the combination treatment group and conventional treatment group(73 cases each group).The conventional treatment group were treated with conventional anti-infectin and corrected respiratory failure,and the combined treatment group were treated with fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration based on the conventional treatment group.The total effective rate,time of fever,time of mechanical ventilation,time of hospitalization,use of antibiotics and pulmonary infection between two groups before and after treatment were compared.Results:The total effective rate in combined treatment group(93.15%)was significantly higher than that in conventional treatment group(78.08%)(P<0.01).The fever time,mechanical ventilation time and hospitalization time in combined treatment group were significantly lower than that in conventional treatment group(P<0.01).The use ratio of triple antibiotics in combined treatment group(8.22%)was significantly lower than that in conventional treatment group(45.21%)(P<0.01).The difference of the CPIS score between two groups before treatment was not statistically significant(P>0.05),which in combined treatment group after 5d and 14d of treatment were significantly lower than that in conventional treatment group(P<0.01).Conclusions:The effect of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration in treating severe pneumonia complicated with type II respiratory failure is good,which can significantly shorten the course of disease,effectively control infection,and reduce the use of antibiotics.It is worthy of clinical promotion.

关 键 词：重症肺炎 Ⅱ型呼吸衰竭 纤维支气管镜 吸痰 灌洗 振动排痰 

分 类 号：R563.1[医药卫生—呼吸系统]