纤维支气管镜引流在低咳嗽峰流速帕金森氏病患者拔管后的应用

发布时间：2018-03-18 13:08

  本文选题：帕金森病　切入点：咳嗽峰流速　出处：《重庆医学》2017年23期 　论文类型：期刊论文

【摘要】：目的探讨纤维支气管镜引流在低咳嗽峰流速(CPEF)帕金森氏病(PD)患者拔管后的应用价值。方法采用前瞻性对照研究方法,选择2011年11月至2015年12月收治PD合并肺部感染需要行气管插管机械通气的26例患者,在顺利通过自主呼吸试验(SBT)1h后嘱患者用力咳嗽,测定CPEF,完成测量后拔除气管插管,根据测定CPEF平均值将其分为高CPEF组(CPEF≥60L/min)和低CPEF组(CPEF60L/min)。高CPEF组患者根据痰液情况由护士床旁吸痰;低CPEF组每天主动给予1次纤维支气管镜引流。将拔管后72h内不需重新插管视为拔管成功。比较两组患者性别、年龄、拔管前急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、机械通气时间、再插管率、拔管后ICU住院时间、28d病死率。结果 26例PD患者中高CPEF组17例,低CPEF组9例。两组在年龄、性别方面比较差异无统计学意义(P0.05);两组拔管前APACHEⅡ评分、两组机械通气时间及28d病死率、再插管率比较无统计学差异(P0.05);低CPEF组拔管后ICU住院时间明显延长(P0.05)。结论低CPEF患者拔管后应用纤维支气管镜引流可以降低再插管率,避免通气时间延长,但不能缩短拔管后ICU住院时间及降低病死率。
[Abstract]:Objective to evaluate the value of fiberoptic bronchoscopic drainage after extubation in patients with Parkinson's disease (PDD) with low cough peak flow velocity (CPEF). From November 2011 to December 2015, 26 patients with PD complicated with pulmonary infection who needed tracheal intubation mechanical ventilation were selected. They were told to cough forcefully and measure CPEF1 h after passing SBT successfully. Tracheal intubation was removed after the measurement was completed. According to the average value of CPEF, they were divided into high CPEF group (CPEF 鈮，

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