床边纤维支气管镜在呼吸衰竭机械通气患者中的应用及护理

目的 探讨纤维支气管镜(简称纤支镜)在呼吸衰竭机械通气患者中应用的临床意义及护理干预.方法 将64例呼吸衰竭机械通气的患者随机分为对照组和治疗组各32例.2组患者均给予全身抗感染、雾化吸入等对症支持治疗及相应护理.治疗组予床边纤支镜肺泡灌洗治疗,对照组常规吸痰治疗.分析比较2组治疗前后的症状、体征及血气分析变化情况.结果 2组的有效率、治愈率比较差异显著;治疗组血气变化、肺部感染控制窗时间、机械通气时间及平均住院时间优于对照组;治疗组成功撤机、器官衰竭及院内死亡例数显著低于对照组.结论 呼吸衰竭机械通气患者行纤支镜肺泡灌洗可改善通气和预后,是安全、有效的.护理干预对提高纤支镜吸痰及灌洗术的成功率起到了不可忽视的重要作用,达到良好的治疗及护理效果.

Abstract：

Objective To investigate the application and nursing care of bronchoalveolar lavage (BAL)by fiberoptic bronchoscopy in patients with mechanical ventilation. Methods 64 patients with mechanical ventilation in RICU were randomly divided into the control group and the observation group with 32 patients in each group. The patients in both groups were accepted anti-infection, atomization inhalation and other supportive treatments. The patients in the observation group were treated with BAL, and the patients in the control group accepted routine treatment. The therapeutic effects in the two groups were evaluated and compared. Results There was significant difference in the recovery rate and effective rate, the blood gas analysis compared with the control group was significantly improved, the time of pulmonary infection control window, mechanical ventilation, length of stay were shorter than the control group. The case number to remove ventilator successfully, organs failure and hospital mortality were less than the control group. Conclusions Fiberoptic bronchoscopy with BAL treatment could be safety and efficacy for patients with mechanical ventilation. Nursing intervention plays an important role and a good therapeutic effect for improving achievement ratio of BAL.

Application and nursing care of bronchoalveolar lavage by fiberoptic bronchoscopy in patients with mechanical ventilation

Objective To investigate the application and nursing care of bronchoalveolar lavage (BAL)by fiberoptic bronchoscopy in patients with mechanical ventilation. Methods 64 patients with mechanical ventilation in RICU were randomly divided into the control group and the observation group with 32 patients in each group. The patients in both groups were accepted anti-infection, atomization inhalation and other supportive treatments. The patients in the observation group were treated with BAL, and the patients in the control group accepted routine treatment. The therapeutic effects in the two groups were evaluated and compared. Results There was significant difference in the recovery rate and effective rate, the blood gas analysis compared with the control group was significantly improved, the time of pulmonary infection control window, mechanical ventilation, length of stay were shorter than the control group. The case number to remove ventilator successfully, organs failure and hospital mortality were less than the control group. Conclusions Fiberoptic bronchoscopy with BAL treatment could be safety and efficacy for patients with mechanical ventilation. Nursing intervention plays an important role and a good therapeutic effect for improving achievement ratio of BAL.