摘要
目的探讨纤维支气管镜在慢性阻塞性肺疾病合并呼吸衰竭机械通气治疗中的应用效果。方法将100例慢性阻塞性肺疾病合并呼吸衰竭的患者按照随机数字表法分为试验组与对照组,各50例。两组均给予常规治疗,给予机械通气治疗法,试验组在此基础上给予纤维支气管吸痰、局部注射抗生素治疗及糖皮质激素处理。比较两组患者治疗前后4 h的动脉血气分析结果,比较两组机械通气时间、住院时间、呼吸机相关肺炎发生率、呼吸机相关肺炎治愈时间及首次撤机成功率,比较两组临床疗效。结果治疗时起两组动脉血二氧化碳分压、动脉血氧分压及血氧饱和度水平均较治疗前显著持续改善(P<0.05或0.01),试验组较对照组改善更显著(P<0.01)。试验组患者住院时间、机械通气时间及呼吸机相关肺炎治愈时间均显著短于对照组(P<0.01),首次撤机成功率显著高于对照组(P<0.01),呼吸机相关肺炎发生率显著低于对照组(P<0.01)。试验组治疗总有效率显著高于对照组(P<0.01)。结论将纤维支气管镜应用于慢性阻塞性肺疾病合并呼吸衰竭机械通气治疗中,可以显著提高临床疗效,缩短机械通气时间及患者住院时间,降低呼吸机相关肺炎发生率,值得推广应用。
Objective To investigate the application effect of fiberoptic bronchoscopy on mechanical ventilation in patients with chronic obstructive pulmonary disease complicated with respiratory failure.Method 100 patients with chronic obstructive pulmonary disease and respiratory failure were randomly divided into the experimental group and the control group,50 cases in each group.Both groups were given conventional treatment and given mechanical ventilation therapy.The experimental group was given fiberbronchoscope suction,local injection of antibiotics and glucocorticoid treatment.The arterial blood gas analysis results of the patients at 4 h before and after treatment were compared.The mechanicaI ventilation time,hospitalization time,ventilator-associated pneumonia rate,ventilator-associated Pneumonia healing time and the success rate of the first weaning were compared.The clinicaI efficacy of the two groups was compared.Result The PaCO2,PaO2,SaO2 of the two groups were significantly improved compared with those before treatment (P<0.05 or 0.01),the experimental group improved more significantly than the control group (P<0.01).The hospitalization time,mechanical ventilation time and ventilator-associated pneumonia healing time of the experimental group were significantly shorter than those of the control group (P<0.01),and the success rate of the first weaning was significantly higher than that of the con- trol group (P<0.01).The incidence of ventilator-associated pneumonia was significantly lower than that of the control group (P<0.01).The total effective rate of the treatment group was significantly higher than that of the control group (P<0.01).Conclusion The application of fiberoptic hronchoscopy on mechanical ventilation in the treatment of chronic obstructive pulmonary disease combined with respiratory failure can significantly improve the clinical efficacy,shorten the mechanical ventilation time and the hospitalizati on time of patients,and reduce the incidence of ventilator-related pneumonia,which is worthy of popularization and application.
作者
刘文先
薛华
李威
Liu Wenxian;Xue Hua;Li Wei(Shangqiu Third People's Hospital,Shangqiu 476000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2019年第1期150-152,172,共4页
Journal of Clinical Psychosomatic Diseases
关键词
慢性阻塞性肺疾病
呼吸衰竭
机械通气
纤维支气管镜
呼吸机相关肺炎
Chronic obstructive pulmonary disease
respiratory failure
mechanical ventilation
fiberoptic bronchoscopy
ventilator-associated pneumonia
