纤维支气管镜对严重呼吸机相关性肺炎患者呼吸力学参数的影响

发布时间：2018-06-13 01:28

本文选题：呼吸机相关性肺炎 + 纤维支气管镜　；参考：《中华医院感染学杂志》2015年08期

【摘要】：目的探讨纤维支气管镜对严重呼吸机相关性肺炎患者临床症状及呼吸力学参数的影响,为临床制定干预措施提供依据。方法选取医院2011年6月-2014年10月收治的80例严重呼吸机相关性肺炎患者作为研究对象,随机分为观察组和对照组,每组各40例,两组患者确诊后均给予常规抗菌药物治疗,对照组在此基础上给予常规灌洗吸痰,观察组则给予纤维支气管镜肺泡灌洗吸痰治疗,对治疗过程中两组患者的呼吸力学参数、肺部感染情况及临床疗效进行比较分析。结果观察组在治疗1h和4h后气道峰压(PIP)、动态顺应性(Cdyn)、气道阻力(Raw)及呼吸功(WOB)参数均明显优于对照组;治疗后两组患者CPIS评分相比治疗前均有不同程度改善,观察组治疗3、5、7d的评分相比对照组明显降低;治疗后观察组痊愈29例占72.5%,显效9例占22.5%,对照组痊愈16例占40.0%,显效18例占45.0%,差异有统计学意义(P0.05)。结论纤维支气管镜肺泡灌洗吸痰治疗严重呼吸机相关性肺炎可有效改善患者的临床感染症状和呼吸功能,具有显著的临床疗效。
[Abstract]:Objective to investigate the effect of fiberoptic bronchoscopy on the clinical symptoms and respiratory mechanical parameters in patients with severe ventilator-associated pneumonia and to provide evidence for clinical intervention. Methods from June 2011 to October 2014, 80 patients with severe ventilator-associated pneumonia were randomly divided into observation group and control group with 40 cases in each group. The patients in both groups were treated with routine antimicrobial agents after diagnosis. The control group was treated with routine lavage and sucking sputum, while the observation group was treated with bronchoalveolar lavage and aspiration. The respiratory mechanical parameters, pulmonary infection and clinical efficacy of the two groups were compared and analyzed. Results the parameters of peak airway pressure (PIP), dynamic compliance (C dyn), airway resistance (AR) and respiratory motility (WOB) in the observation group were significantly better than those in the control group after 1 h and 4 h of treatment, and CPIS scores of the two groups were improved in different degrees after treatment. The scores of the observation group were significantly lower than that of the control group, the scores of the observation group were significantly lower than that of the control group, and 29 cases were cured in the observation group (72.5 cases), 9 cases had remarkable effect (22.5D), 16 cases in the control group (40.05%) and 18 cases (45.0%) in the control group, the difference was statistically significant (P 0.05). Conclusion bronchoalveolar lavage and sputum aspiration in the treatment of severe ventilator-associated pneumonia can effectively improve the clinical infection symptoms and respiratory function of patients with significant clinical efficacy.
【作者单位】：武汉市中心医院呼吸内科;东莞市塘厦医院中医科;
【基金】：广东省卫生厅基金资助项目(A20026725)
【分类号】：R563.1

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