纤维支气管镜肺泡灌洗联合序贯机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床效果观察

目的:探讨纤维支气管镜肺泡灌洗联合序贯机械通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床效果。方法:选择慢性阻塞性肺疾病合并呼吸衰竭患者62例,上述患者随机分为观察组和对照组。两组患者均给予常规治疗,对照组患者采用有创机械通气;观察组患者采用有创-无创序贯通气治疗,同时行纤维支气管镜肺泡灌洗。结果:观察组切换时间窗PaO2、PaCO2和pH分别与对照组比较,差异有统计学意义(P<0.05);观察组机械通气时间、住院时间、呼吸机相关肺炎发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论:纤维支气管镜肺泡灌洗联合序贯机械通气治疗能够显著改善COPD合并呼吸衰竭患者临床症状,缩短机械通气时间,降低机械通气并发症。

Clinical efficacy of bronchoalveolar lavage by fibre bronchoscope and sequential mechanical ventilation on COPD complicated with respiratory failure

Objective To explore the clinical efficacy of bronchoalveolar lavage and sequential mechanical ventilation on COPD complicated with respiratory failure. Method Total 62 cases with COPD complicated with respiratory failure were selected and randomly divided into the observation group and the control group. The routine treatment was used to the two groups, invasive mechanical ventilation was given to the control group, invasive - noninvasive and bronchoalveolar lavage by fibre bronchoscope were used to the observation group. Results PaO2, PaCO2 and pH in the observation group at switching time compared with those in the control group, there was statistical difference （ P 〈 0. 05 ） ; the time of mechanical ventilation, hospitalization time and the rate of ventilator - associated pneumonia in the observation group compared with those in the control group, there was statistical difference （P 〈 0. 05 ）, Conclusion Bronchoalveolar lavage and sequential mechanical ventilation can improve the symptoms of patients with COPD complicated with respiratory failure, shorten the time of mechanical ventilation and decrease the rate of complications caused by mechanical ventilation.