纤维支气管镜联合肺泡灌洗术治疗呼吸机相关性肺炎患者的临床疗效分析

目的 探讨采用纤维支气管镜联合肺泡灌洗术治疗呼吸机相关性肺炎患者的临床疗效。方法 选择我院2013年1月至2014年4月呼吸科诊断为呼吸机相关性肺炎的160例患者,随机分成对照组80例和治疗组80例。对照组采用常规的控制肺部感染的治疗措施,治疗组除了常规的控制肺部感染的治疗措施,还采用纤维支气管镜联合肺泡灌洗术进行治疗。分别记录两组患者的pH、PaO2、PaCO2、SpO2、MAP（mmHg）、H（次/min）、气道阻力（cmHg）、抗生素应用时间;机械通气时间、脱机成功率;患者的显效,有效,无效的情况。结果 治疗组的pH、PaO2、PaCO2、SpO2、MAP（mmHg）、H（次/min）、气道阻力（cmHg）、抗生素应用时间与对照组比较,差异有统计学意义,P〈0.05;两组患者的机械通气时间、脱机成功率的治疗后情况对比,差异有统计学意义,P〈0.05;χ^2=3.602,P〈0.05,差异有统计学意义。两组患者的治疗有效率情况对比,对照组：显效18例（22.5%）,有效34例（42.5%）,无效28例（35.0%）,总有效率52例（65.0%）;治疗组：显效30例（37.5%）,有效46例（57.5%）,无效4例（5.0%）,总有效率76例（95.0%）,治疗组患者的总有效率高于对照组的总有效率。结论 纤维支气管镜联合肺泡灌洗术是治疗呼吸机相关性肺炎患者的安全有效的方法,可改善患者的通气质量,提高血氧饱和度,提高患者治疗的有效率,值得临床推广。

Clinical efficacy of fiberoptic bronchoscopy with bronchoalveolar lavage in the treatment of patients with ventilator associated pneumonia

Objective To investigate clinical efficacy of the fiberoptic bronchoscopy with bronchoalveolar lavage in the treatment of patients with ventilator associated pneumonia, provide evidence for clinical therapy theory. Methods It was collected that 160 patients with ventilator-associated pneumonia in our hospital from 2013 January to 2014 April in Department of Respiration, they were randomly divided into two groups, the treatment group 80 cases and the control group 80 cases. The control group used conventional methods to control lung infection, the treatment group in addition to conventional Department of Respiration to control lung infection treatment, were treated by fiberoptic bronchoscopy with bronchoalveolar lavage. Two groups of patients were recorded in pH, PaO2, SpO2, MAP（ mmHg）, PaCO/, H（/min） , airway resistance （cmHg）, application time of antibiotics; the duration of mechanical ventilation, the rate of successful weaning; patients markedly effective, effective, invalid case. Results It was comparted that, PaO2, pH, PaC02, SpO2, MAP （mmHg）, H （/min）, airway resistance （cmHg）, the application of antibiotics in the treatment group and control group before and after treatment： P 〈 0.05, the difference was statistically significant ; the success rate compared with the control group, P 〈 0.05, the difference was statistically significant ; contrast treatment duration of mechanical ventilation, two groups of patients with the rate of successful weaning of mechanical ventilation time ： P 〈 0.05, the difference was statistically significant. Treatment of two groups of patients with effective rate of control group： contrast, markedly effective in 18（22.5% ）, 34（42.5% ）, invalid 28 （35%）, the total efficiency of 52 （65%）; treatment group： excellent in 30 （37.5%）, 46 （57.5%）, invalid 4（5% ）, the total efficiency of 76（95% ） patients in the treatment group, the total efficiency is higher than the control group in the total efficiency. Conclusions F