静脉镇静联合纤维支气管镜吸痰治疗慢性阻塞性肺疾病急性加重

目的：探讨静脉镇静对改善慢性阻塞性肺疾病（COPD）急性加重期（ AECOPD）躁动患者纤维支气管镜（纤支镜）吸痰治疗效果的影响。方法67例伴有躁动的AECOPD患者随机分为观察组34例和对照组33例,观察组给予静脉镇静治疗,目标Ramsay评分为2,两组其他治疗相同。结果观察组、对照组的气管插管率分别为23.5%和69.7%,两组气管插管率比较差异有统计学意义（P〈0.01）；观察组住ICU时间、住院时间分别为（7±177;5） d、（11±177;7） d,对照组住ICU时间、住院时间分别为（11±177;6） d、（15±177;8） d,观察组的住ICU时间及住院时间均比对照组明显缩短（P〈0.05）。治疗后28 d,观察组、对照组分别有2例、10例患者死亡,病死率分别为5.9%、30.3%；病死率明显低于对照组（P〈0.01）。结论静脉镇静可以提高AECOPD伴躁动患者治疗成功率,减少气管插管率,降低患者病死率,改善患者预后。

Intravenous sedation combined fiberoptic bronchoscopic sputum aspiration therapy in acute exacerbations of chronic obstructive pulmonary disease

Objective To explore the value of intravenous sedation combined fiberoptic bronchoscopic sputum aspiration in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） patients with restlessness. Methods 67 cases of AECOPD patients with restlessness were randomly divided into observation group （n=34） and control group （n=33）. The observation group was given intravenous sedation ,with target Ramsay score of 2 . other treatments were same. Results The endotracheal intubation rate of the observation group and the control group were 23.5%and 69.7%respectively. there was statistically significant difference between the two groups （P＆lt;0 01） . The ICU stay and hospital stay of the observation group were （7＆#177;5） ds, （11＆#177;7） ds, and （11＆#177;6） ds, （15＆#177;8） ds for the control group. The front group was significantly shorter than the latter group on ICU stay and hospital stay （P＆lt;0.05）. After treatment for 28 ds, 2 cases of the observation group died and 10 cases died in the control group , the mortality was 5.9%, 30.3%respectively. the mortality of the observation group was significantly lower than the control group （P＆lt;0.01）. Conclusion For the AECOPD patients with restlessness, intravenous sedation may improve the treatment success rate, reduce the endotracheal intubation rate and the mortality , and improve their outcomes.