纤维支气管镜吸痰联合肺泡灌洗在呼吸机相关性肺炎治疗中的应用

发布时间：2019-05-18 14:17

【摘要】：目的探讨纤支镜吸痰联合肺泡灌洗在呼吸机呼吸机相关性肺炎(VAP)治疗中的临床价值。方法对2012年12月至2013年7月收住某院重症医学科(ICU)的76例VAP患者随机分为实验组和对照组,实验组采取常规治疗+纤支镜吸痰联合肺泡灌洗,对照组采取常规治疗,分别对两组患者的机械通气时间、ICU住院天数、ICU住院费用、简化临床肺部感染评分、痰细菌培养阳性率进行比较,同时比较实验组纤支镜吸痰联合肺泡灌洗前后的氧和指数及心输出量、体循环阻力、平均动脉压。结果实验组机械通气时间、ICU住院天数较对照组显著缩短(P0.05);ICU住院费用明显低于对照组(P0.05);在病后第3、5、7天实验组的简化临床肺部感染评分均显著低于对照组(P0.05);实验组较对照组痰细菌培养阳性率高(P0.05)。纤支镜吸痰联合肺泡灌洗后1 h较操作前5 min氧和指数有所改善(P0.05),心输出量、体循环阻力、平均动脉压变化不明显(P0.05)。结论纤支镜吸痰联合肺泡灌洗在VAP治疗中的应用效果较好且安全。
[Abstract]:Objective to investigate the clinical value of fiberoptic bronchoscopy combined with alveolar lavage in the treatment of ventilator-associated pneumonia (VAP). Methods 76 patients with VAP who received (ICU) from December 2012 to July 2013 were randomly divided into experimental group and control group. The experimental group was treated with fiberoptic bronchoscopy combined with alveolar lavage, and the control group was treated with routine treatment. The mechanical ventilation time, ICU hospitalization days, ICU hospitalization expenses, simplified clinical pulmonary infection score and sputum bacterial culture positive rate were compared between the two groups. At the same time, the oxygen and index, cardiac output, systemic circulation resistance and mean arterial pressure before and after sputum aspiration combined with alveolar lavage in the experimental group were compared. Results the duration of mechanical ventilation and the hospitalization days of ICU in the experimental group were significantly shorter than those in the control group (P 0.05). The hospitalization cost of); ICU in the experimental group was significantly lower than that in the control group (P 0.05). On the 3rd, 5th and 7th day after the disease, the scores of simplified clinical pulmonary infection in the experimental group were significantly lower than those in the control group (P 0.05), and the positive rate of sputum bacterial culture in the experimental group was higher than that in the control group (P 0.05). Compared with 5 min oxygen and index before operation, the oxygen and index of fiberoptic bronchoscopy combined with alveolar lavage were improved 1 hour after operation (P 0.05), but cardiac output, systemic circulation resistance and mean arterial pressure did not change significantly (P 0.05). Conclusion Fiberoptic bronchoscopy combined with alveolar lavage is effective and safe in the treatment of VAP.
【作者单位】：新疆医科大学第五附属医院ICU;新疆医科大学第一附属医院ICU;
【基金】：乌鲁木齐市科学技术计划项目(No.Y111310024)
【分类号】：R563.1

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