机械通气联合支气管肺泡灌洗治疗COPD合并呼吸衰竭随机对照研究

发布时间：2018-03-04 18:34

本文选题：机械通气　切入点：支气管肺泡灌洗　出处：《实用医学杂志》2014年18期 　论文类型：期刊论文

【摘要】：目的:探讨机械通气下支气管镜吸痰及支气管肺泡灌洗(BAL)对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的疗效。方法:60例COPD合并呼吸衰竭均实施有创机械通气,对照组用吸痰管常规吸痰,灌洗组在对照组治疗基础上行BAL,观察两组在治疗前后各项指标变化。结果:灌洗组治疗后1 h SpO2、4 d气道吸气峰压及动脉血气较对照组明显改善(P0.01);灌洗组治疗后7 d白细胞总数(WBC)和C反应蛋白(CRP)水平较对照组明显降低(P0.01);灌洗组有创通气时间及住院时间均较对照组均明显下降(P0.01),两组均无严重并发症。结论:在机械通气支持下,行气管镜BAL是安全有效的,并且能缩短COPD合并呼吸衰竭患者住院时间及改善患者病情。
[Abstract]:Objective: to evaluate the efficacy of bronchoscope sputum aspiration and bronchoalveolar lavage (BAL) in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods: 60 cases of COPD with respiratory failure were treated with invasive mechanical ventilation. In the control group, the sputum suction tube was used routinely. BALs were performed in the lavage group on the basis of the control group, and the changes of the indexes before and after treatment were observed. Results: the peak inspiratory pressure and arterial blood gas of the lavage group were significantly improved than that of the control group at 1 h after treatment, and 7 hours after the treatment in the lavage group. D WBC) and C reactive protein (CRP) levels were significantly lower in the lavage group than in the control group, and the duration of invasive ventilation and hospitalization in the lavage group were significantly lower than those in the control group, and there were no serious complications in both groups. Conclusion: under the support of mechanical ventilation, there are no serious complications in both groups. Tracheoscopy BAL is safe and effective, and can shorten the hospitalization time and improve the condition of COPD patients with respiratory failure.
【作者单位】：淮安市第一人民医院呼吸科;
【分类号】：R563.9;R563.8

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