纤维支气管镜下肺泡灌洗对呼吸机相关性肺炎患者感染控制及呼吸功能的影响  

Effect of Alveolar Lavage under Fiberoptic Bronchoscope on Infection Controland Respiratory Function in Patients with Ventilator-associated Pneumonia

作　　者：袁博[1] YUAN Bo(Department of Critical Care Medicine,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院重症医学科,黑龙江佳木斯154002

出　　处：《医学信息》2020年第22期117-119,共3页Journal of Medical Information

摘　　要：目的探讨纤维支气管镜下肺泡灌洗对呼吸机相关性肺炎患者感染控制及呼吸功能的影响。方法选取2016年2月~2019年4月我院收治的呼吸机相关性肺炎患者86例,按照随机数字表法分为对照组和观察组,每组43例。对照组给予常规肺部感染治疗,观察组在对照组的基础上联合纤维支气管镜下肺泡灌洗治疗,比较两组治疗前后呼吸力学参数(PIP、CD、RAW、WOB)、炎症因子(CRP、IL-8、PCT)及血气水平(PaO2、PaCO2)。结果治疗后,观察组RAW、PIP、WOB低于对照组,CD高于对照组,差异有统计学意义(P<0.05);两组治疗后PaO2较治疗前升高,PaCO2较治疗前降低,且观察组PaO2高于对照组,PaCO2低于对照组,差异有统计学意义(P<0.05);观察组CRP、IL-8及PCT低于对照组,差异有统计学意义(P<0.05)。结论肺部感染联合纤维支气管术下肺泡灌洗术治疗呼吸机相关性肺炎,可减少抗生素的使用,促进患者有效排痰,加快肺通气,改善呼吸功能,降低炎症因子水平,促进感染控制。Objective To investigate the effect of fiberoptic bronchoscopic alveolar lavage on infection control and respiratory function in patients with ventilator-associated pneumonia.Methods A total of 86 patients with ventilator-associated pneumonia admitted to our hospital from February 2016 to April 2019 were selected and divided into control group and observation group according to the random number table method,with 43 cases in each group.The control group was given conventional lung infection treatment,and the observation group was combined with fiberoptic bronchoscope alveolar lavage on the basis of the control group.The respiratory mechanics parameters(PIP,CD,RAW,WOB),inflammatory factors(CRP,IL-8,PCT)and blood gas levels(PaO2,PaCO2).Results After treatment,the RAW,PIP,WOB of the observation group were lower than those of the control group,and the CD was higher than that of the control group,the difference was statistically significant(P<0.05);PaO2 after treatment was higher than before treatment,and PaCO2 was lower than before treatment.And PaO2 of the observation group was higher than the control group,PaCO2 was lower than the control group,the difference was statistically significant(P<0.05);the observation group CRP,IL-8 and PCT were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Pulmonary infection combined with fibrobronchial alveolar lavage in the treatment of ventilator-associated pneumonia can reduce the use of antibiotics,promote effective sputum excretion,speed up lung ventilation,improve respiratory function,reduce inflammatory factor levels,and promote infection control.

关 键 词：纤维支气管镜 肺泡灌洗 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]