常规支气管肺泡灌洗在COPD患者有创机械通气的应用的研究

发布时间：2018-04-17 00:21

本文选题：支气管肺泡灌洗 + 有创机械通气　；参考：《川北医学院》2012年硕士论文

【摘要】：目的：观察在使用有创机械通气的慢性阻塞性肺疾病（COPD）患者中进行常规支气管肺泡灌洗的疗效。方法：96例COPD合并Ⅱ型呼吸衰竭患者在有创机械通气的基础上，通过常规吸痰术分为有痰组和无痰组，有痰组随机分为两组，一组继续给予有创机械通气，简称A组，另一组在有创机械通气的基础上每天予以支气管肺泡灌洗，简称B组；无痰组亦随机分为两组，一组继续给予有创机械通气，简称C组，另一组在有创机械通气的基础上每天予以支气管肺泡灌洗，简称D组。观察四组患者血气指标（pH、PaCO_2、PaO_2），有创机械通气时间，RICU住院天数，RICU住院费用结果：有痰组患者在治疗后pH大致恢复到正常范围，PaCO_2下降，，PaO_2升高，两组比较差异有统计学意义（P0.05）；转归方面，B组的机械通气时间、RICU住院时间以及RICU使用费用等均较A组短（P0.05）；无痰组患者在治疗后pH亦恢复到正常范围，PaCO_2下降，PaO_2升高，两组比较差异无统计学意义（P＞0.05）；转归方面，D组的机械通气时间、RICU住院时间以及RICU费用等亦较C组短，但两组比较差异无统计学意义（P＞0.05）。结论：在有痰组中常规支气管肺泡灌洗在COPD合并Ⅱ型呼吸衰竭患者中应用均较单纯使用有创机械通气更能使PaCO_2降低明显，PaO_2升高明显，pH恢复明显；且亦缩短了机械通气时间、RICU住院时间以及节省了RICU住院费用；而在无痰组中常规支气管肺泡灌洗在COPD合并Ⅱ型呼吸衰竭患者中应用较单纯使用有创机械通气PaCO_2有降低，PaO_2有升高，pH有恢复，机械通气时间、RICU住院时间有所缩短以及RICU住院费用减少，但两组比较差异无统计学意义，须待进一步研究。
[Abstract]:Objective: To observe the effect of conventional bronchoalveolar lavage in patients with chronic obstructive pulmonary disease (COPD) using invasive mechanical ventilation.
Methods: 96 cases of COPD patients with type II respiratory failure on the basis of mechanical ventilation, through conventional sputum suction were divided into phlegm group and non phlegm group phlegm group were randomly divided into two groups, one group to continue to give the invasive mechanical ventilation, referred to as A group, another group in the foundation mechanical ventilation on the day to bronchoalveolar lavage, referred to as B group; no phlegm group were randomly divided into two groups, one group to continue to give the invasive mechanical ventilation, referred to as C group, another group in the basis of mechanical ventilation on the day of bronchoalveolar lavage, referred to as D group. Four groups were observed in patients with blood gas index (pH, PaCO_2, PaO_2), mechanical ventilation time, RICU length of stay, hospitalization costs RICU
Results: the sputum group of patients after treatment of pH return to the normal range, PaCO_2 decreased, PaO_2 increased, there was significant difference between two groups (P0.05); outcome, the duration of mechanical ventilation in group B, RICU and RICU use the cost of hospitalization were shorter than those of group A (P0.05); group of patients without sputum after treatment of pH also returned to normal range, PaCO_2 decreased, PaO_2 increased, the difference between the two groups was not statistically significant (P > 0.05); prognosis, duration of mechanical ventilation in group D, RICU and RICU also cost the hospitalization time was shorter than that of group C, but the two groups but no significant difference (P > 0.05).
Conclusion: in the conventional bronchoalveolar lavage sputum group in the COPD patients with type II respiratory failure in the application are relatively simple use of invasive mechanical ventilation can cause PaCO_2 decreased significantly, PaO_2 increased significantly, pH recovery is obvious; and also shorten the mechanical ventilation time, RICU stay and save the hospitalization expenses and RICU; in the absence of routine bronchoalveolar lavage sputum group in the COPD patients with type II respiratory failure in the application of a simple use of invasive mechanical ventilation in PaCO_2 decreased, PaO_2 increased, pH recovery, mechanical ventilation time, hospitalization time was shortened RICU and RICU reduced hospitalization costs, but the difference between the two groups was not statistically significant, subject to further study.

【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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