床旁纤维支气管镜吸痰联合无创正压通气治疗慢性阻塞性肺疾病急性加重期的效果观察  

Observation of effect of bedside flexible bronchoscopy sputum aspiration combined with noninvasive positive pressure ventilation on acute exacerbation of chronic obstructive pulmonary disease

作　　者：魏然[1] 朱婉凌[1] 贾金广 忽新刚[2] Wei Ran;Zhu Wanling;Jia Jinguang;Hu Xingang(Department of Respiratory and Critical Care Medicine,People’s Hospital of Zhengzhou,Zhengzhou 450003,China;Department of Respiratory and Critical Care Medicine,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院呼吸与危重症医学科,郑州450003 [2]河南省人民医院呼吸与危重症医学科,郑州450003

出　　处：《中国实用医刊》2023年第18期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨床旁纤维支气管镜吸痰联合无创正压通气(NPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期的临床效果。方法抽取2019年8月至2022年7月郑州人民医院收治的COPD急性加重期患者50例,按随机数字表法将患者分为NPPV组和研究组,每组25例。NPPV组采用NPPV治疗,研究组在NPPV组基础上采用床旁纤维支气管镜吸痰治疗。比较两组疗效,比较两组治疗前后血气指标[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))]、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV1)/FVC],比较两组不良反应发生率。结果研究组总有效率(96.00%,24/25)高于NPPV组(68.00%,17/25),P<0.05。治疗后,研究组PaO_(2)、SaO_(2)水平高于NPPV组,PaCO_(2)水平低于NPPV组(P<0.05);治疗后,研究组HR、呼吸频率、DBP、SBP水平低于NPPV组(P<0.05);治疗后,研究组FVC、FEV1/FVC水平高于NPPV组(P<0.05)。研究组不良反应发生率(16.00%,4/25)与NPPV组(8.00%,2/25)比较差异未见统计学意义(P>0.05)。结论床旁纤维支气管镜吸痰联合NPPV治疗COPD急性加重期临床效果显著,能改善血气指标和肺功能,且治疗安全性较高。Objective To investigate the clinical effect of bedside flexible bronchoscopy sputum aspiration combined with noninvasive positive pressure ventilation(NPPV)on acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Fifty patients with acute exacerbation of COPD treated in People’s Hospital of Zhengzhou from August 2019 to July 2022 were selected,and they were divided into NPPV group and study group by random number table method,with 25 cases in each group.The NPPV group was treated by NPPV,and the study group was treated by bedside flexible bronchoscopy sputum aspiration based on the treatment of the NPPV group.The curative effect of the two groups were compared.The blood gas indexes,including arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and arterial oxygen saturation(SaO_(2)),lung function assessed by forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1)/FVC were compared between the two groups before and after treatment.The incidence of adverse reactions of the two groups were compared.Results The total effective rate of the study group was 96.00%(24/25),higher than the 68.00%(17/25)of the NPPV group(P<0.05).After treatment,the study group had higher levels of PaO_(2)and SaO_(2),but lower level of PaCO_(2),compared with the NPPV group(P<0.05).Compared with the NPPV group,levels of FVC and FEV1/FVC in the study group were higher after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(16.00%,4/25)and the NPPV group(8.00%,2/25),P>0.05.Conclusions Bedside flexible bronchoscopy sputum aspiration combined with NPPV has a significant effect in the treatment of acute exacerbation of COPD,which can improve blood gas indexes and lung function,with high treatment safety.

关 键 词：慢性阻塞性肺疾病 急性加重期 支气管镜 无创正压通气 

分 类 号：R563.9[医药卫生—呼吸系统]