纤维支气管镜在吸入性损伤患者肺部感染治疗中应用的效果评价

目的 观察纤维支气管镜在吸入性损伤肺部感染治疗中的临床效果.方法 选择我院2005年1月至2012年12月间收治的大面积烧伤伴重度吸入性损伤患者92例,所有患者均应用纤维支气管镜进行诊断并通过床边纤维支气管镜进行治疗,观察患者治疗前及治疗两周后心率、动脉血气分析pH、血氧分压（PaO2）、二氧化碳分压（PaCO2）、静脉血氧饱和度（SaO2）]和白细胞（WBC）改变及治疗效果.结果 中度吸入性损伤70例,14例病情稳定,3周内治愈拔除气管套管,56例患者应用呼吸机辅助呼吸治疗,经抢救37例成功,19例死亡,死亡原因为急性呼吸窘迫综合征,治愈率为72.9％;重度吸入性损伤22例,2例病情稳定,20例出现呼吸衰竭,经抢救9例成功,11例死亡,6例死亡原因为败血症,5例死亡原因为多脏器功能衰竭,治愈率为50.0％.患者治疗后心率、血气分析指标明显改善,治疗后WBC计数较治疗前明显降低（P＜0.05）.结论 纤维支气管镜在吸入性损伤患者救治中有很大的应用价值,可以有效提高救治效果,值得临床推广应用.

Application of fibrotic bronchoscope in lung infection caused by inhalation injury

Objective To assess the application of fibrotic bronchoscope in lung infection caused by inhalation injury.Methods Ninety-two patients of inhalation injury were selected from January 2005 to December 2012,and fibrotic bronchoscope were applied for diagnosis and treatment.The heart rate,pH,Pa02,PaCO2,SaO2 and white blood cell （WBC） changes after 2 weeks were observed.Results Seventy patients of moderate inhalation injury were found,of which 14 showed stable disease and were cured in 3 week with tracheostomy tube removed.Fifty-six patients applied ventilation as accessory respiratory therapy,of which 37 were successfully rescued and 19 died of acute respiratory distress syndrome.The cure rate was 72.9%.Twenty-two patients of severe inhalation injury were found,of which 2 showed stable disease and 20 showed respiratory failure （Nine were successfully rescued and 11 died,of which 6 died of sepsis and 5 died of multiple organ failure）,with the cure rate of 50%.Heart rate,blood gas analysis indicators in patients significantly improved after treatment,and WBC counts significantly decreased after treatment,（P〈0.05）.Conclusion Fibrotie bronehoscope has great value in patients with inhalation injury treatment and can significantly improve the treatment effect,which is worthy of clinical promotion.