经纤维支气管镜支气管肺泡灌洗对机械通气治疗溺水后呼吸衰竭的影响

目的观察经纤维支气管镜支气管肺泡灌洗对淹溺淡水污水后出现呼吸衰竭给予机械通气治疗的患者的疗效影响。方法35例淹溺污水后行机械通气治疗的患者,其中男性23例,女性12例;年龄18～67岁,平均年龄42.5岁。入院48 h内在机械通气状态下行经纤维支气管镜支气管肺泡灌洗治疗,比较入院时和入院48 h两组呼吸生理、呼吸力学及临床指标。结果抢救成功32例,死亡3例。与入院时相比,入院48 h氧合指数、呼吸频率、体温、吸气峰压等呼吸生理、呼吸力学及临床指标明显改善,比较上述两组指标,差异均有统计学意义(P<0.05),术中指脉氧监测无明显下降。结论经纤维支气管镜支气管肺泡灌洗在机械通气状态下治疗溺水所致呼吸衰竭的患者安全有效。

Effect of bronchoalveolar lavage by bronchofibroscope in patients with respiratory failure caused by drowning for mechanical ventilation

Objective To study the affect of mechanical ventilation of patient with respiratory failure in drowning with bronchoalveolar lavage(BAL) by bronchofibroscope.Methods A total of 35 patients with respiratory failure in drowning were enrolled,male 23,female 12,aged 18-67 years old,mean age 42.5 years old.They were treated with BAL by bronchofibroscope which mechanical ventilation undergoing at admission 48 hours.Anapnea physiology indexes,breathing mechanics indexes and clinical indexes were detected on admission and admission to 48 hours.Results The successful rescue were 32 cases,dead 3 cases.Oxygenation index,respiratory frequency,body temperature,peak airway pressure and respiratory physiology respiratory mechanics,clinical indexes on admission 48 hours were significantly improved;there were significantly different than that on admission(P < 0.05).And percutem SATO2 hadn’t decreased obviously when accepted BAL.Conclusion It is effective and safety that BAL by bronchofibroscope treats patients with respiratory failure in drowning when accept mechanical ventilation.