纤维支气管镜肺灌洗联合机械正压通气对重症肺不张患者的治疗研究

目的:研究纤维支气管镜肺灌洗联合机械正压通气对重症肺不张患者的治疗可行性及治疗效果。方法:对31例重症肺不张患者在综合治疗的基础上行机械通气和纤维支气管镜肺灌洗,监测患者生命体征、动脉血气分析,对治疗前后各项指标及临床情况进行对比分析。术后继续持续气道正压机械通气治疗,治疗后第3天复查胸部CT,对病情严重患者进行二次灌洗。结果:术中10%患者会出现血压升高,脉氧短暂轻度下降,心率增快,但所有患者都能顺利完成治疗。治疗前后各项生命体征基本平稳,多数指标变化不大,氧合指标有明显改善,复查胸部CT显示肺复张率达90%。结论:纤维支气管镜肺灌洗联合机械正压通气治疗重症肺不张是安全有效的方法。

Study of Bronchofibroscope Lung Lavage combined with Mechanical Positive Pressure Ventilation in the Treatment of Severe Patients with Pulmonary Atelectasis

Objective： Study on the feasibility of treatment and therapeutic efficacy of bronchofibroscope lung lavage combined with mechanical positive pressure ventilation on severe patients with pulmonary atelectasis. Methods： 31 Patients with severe pulmonary atelectasis were given bronchofibroscope lung lavage and mechanical ventilation on the basis of multimodality therapy, with vital signs monitored and arterial blood gases analyzed simultaneously. Indexes and clinical setting before and after the Cerement were compared afterwards. After operation, they were under continuous mechanical positive pressure ventilation treamlent. All patients were rechecked chest CT the third day after treatment and the seriously ill were carried out second lavage. Results All patients completed the treatment with basically stable vital signs bcfor and after lxeatmcnt, little change in most indicators, a significant improvement in oxygenation index and lung recruitment rate up to 90%, in spite of 10% patients with increased blood pressure,momentary decreased pulse oximeUy and increased heart rate during the treatment. Conclusion： Bronchofibroscope lung lavage combined with mechanical positive pressure ventilation is effective, safe and reliable in the treatment of severe patients with pulmonary atelectasis.