经支气管镜清除肺曲霉菌球术治疗的患者特点及护理对策

目的　探讨经支气管镜清除肺曲霉菌球治疗患者特点及对策。方法　本研究为回顾性研究,选取2018年11月至2020年12月广州市胸科医院经支气管镜清除肺曲霉菌球治疗患者52例作为治疗组,其中男46例、女6例,年龄（47.00±13.48）岁;另选取同期支气管镜普通诊疗操作患者52例作为对照组,男44例、女8例,年龄（48.00±16.28）岁。比较两组患者心率、血氧饱和度、血压、操作时间以及出血差异。计量资料采用独立样本t检验,计数资料采用χ²检验。结果　治疗组心率、操作时间分别为（112.0±6.46）次/min、（39.95±8.32）min,均高于对照组的（100.0±9.11）次/min、（8.83±2.46）min,血氧饱和度为（96.0±0.69）%,低于对照组（98.0±1.11）%,差异均有统计学意义（均P<0.05）;两组气管镜操作患者收缩压和舒张压比较,差异均无统计学意义（均P>0.05）。治疗组镜检出血发生率为48.08%（25/52）,高于对照组0.00%（0/52）,两组比较差异有统计学意义（χ²=32.911,P<0.001）。结论　经支气管镜清除肺曲霉菌球治疗的患者更加紧张,发生低氧血症、出血的风险高;采用术前、术中及术后护理对策,控制高危因素,把握治疗时机是预防严重并发症的关键。

Characteristics of patients undergoing bronchoscopic removal of pulmonary aspergilloma and nursing countermeasures

Objective　To explore the characteristics and countermeasures of patients treatedby bronchoscopic removal of pulmonary aspergilloma. Methods　This study was a retrospective study. The clinical data of 52 patientsundergoing bronchoscopic removal of pulmonary aspergilloma (the treatmentgroup) and 52 patients undergoing ordinary bronchoscopy (the control group)were reviewed in Guangzhou Chest Hospital from November 2018 to December 2020.There were 46 males and 6 females in the treatment group, with an age of(47.00±13.48) years old; there were 44 males and 8 females in the controlgroup, with an age of (48.00±16.28) years old. The differences of heart rate,oxygen saturation, blood pressure, operation time, and bleeding were comparedbetween the two groups. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　The heart rate and operation time of the treatment group were(112.0±6.46) beats/min and (39.95±8.32) min, respectively, which were higherthan those of the control group [(100.0±9.11) beats/min and (8.83±2.46) min],and the blood oxygen saturation was (96.0±0.69)%, which was lower than that ofthe control group [(98.0±1.11)%], with statistically significant differences(all P<0.05). There were nostatistically significant differences in the systolic blood pressure anddiastolic blood pressure between the two groups (both P>0.05). The incidence of microscopic bleeding in the treatmentgroup was 48.08% (25/52), which was higher than that in the control group[0.00% (0/52)], with a statistically significant difference between the twogroups (χ²=32.911, P<0.001). Conclusions　Patients treated with bronchoscopic removal of pulmonary aspergillomaare more tense and have a high risk of hypoxemia and hemorrhage. Adoptingpreoperative, intraoperative, and postoperative nursing strategies, control ofhigh-risk factors, and grasping the timing of treatment play key roles inpreventing serious complications.