纤维支气管镜联合振动排痰治疗鼻咽癌放疗后吸入性肺炎的效果

目的 探讨纤维支气管镜联合振动排痰治疗对鼻咽癌放疗后吸入性肺炎患者临床症状及呼吸功能的影响。方法 选择我院2016年3月—2019年1月收治的鼻咽癌放疗后吸入性肺炎患者56例,随机分为对照组和观察组,各28例,对照组采用振动排痰治疗,观察组采用纤维支气管镜吸痰灌洗联合振动排痰法,比较两组临床肺部感染评分(CPIS)、急性生理与慢性健康状况评分(APACHEⅡ)、临床症状改善情况、呼吸功能指标。结果 治疗后,2组CPIS、APACHEⅡ评分均降低,且观察组CPIS评分(2.76±2.03)、APACHEⅡ评分(10.51±6.38)低于对照组CPIS评分(4.15±2.76)、APACHEⅡ评分(16.92±8.46),差异有统计学意义(P<0.05);治疗后,2组PaO2 、PaO2/FiO2水平均较治疗前增加,且观察组PaO2水平(89.46±4.59)、PaO2/FiO2水平(276.64±11.89)高于对照组PaO2水平(82.27±3.89)、PaO2/FiO2水平(250.43±10.28),差异有统计学意义(P<0.05);观察组发热持续时间(4.62±1.98)、住院时间(9.57±2.56)均低于对照组发热持续时间(6.93±2.65)、住院时间(12.58±3.23),差异有统计学意义(P<0.05)。结论 纤维支气管镜联合振动排痰治疗可改善鼻咽癌放疗后吸入性肺炎患者呼吸功能,缩短住院时间,利于患者预后。

Effect of fiberoptic bronchoscopy combined with vibrating sputum excretion treatment on patients with aspiration pneumonia after radiotherapy for nasopharyngeal carcinoma

Objective To investigate the effect of fiberoptic bronchoscopy combined with vibrating sputum excretion treatment on clinical symptoms and respiratory function of patients with aspiration pneumonia after radiotherapy for nasopharyngeal carcinoma. Methods A total of 56 patients with aspiration pneumonia from March 2016 to January 2019 were randomly divided into a control group and a trial group, with 28 cases in each group. The control group was treated by vibrating sputum excretion, and the trial group was treated by fiberoptic bronchoscopy combined with vibrating sputum excretion. The clinical pulmonary infection scores (CPIS), acute and chronic health scores (APACHE II), improvement of clinical symptoms, and respiratory function parameters were investigated and compared between two groups. Results After the treatment, the scores of CPIS and APACHE Ⅱ in both groups were lower than those before the treatment, and in addition, the average CPIS score was (2.76±2.03) and APACHE Ⅱ score was (10.51±6.38) in the trial group, which were lower than those in the control group , and there were significant differences (both P<0.05). After the treatment, the levels of PaO2 and PaO2/FiO2 were increased in both groups, and in addition, the average PaO2 level was (89.46±4.59) mmHg and PaO2/FiO2 was (276.64±11.89) in the trial group, which were higher than those in the control group , and there were significant differences (both P<0.05). The time of fever duration was (4.62±1.98) days and the time of hospitalization was (9.57±2.56) days in the trial group, which were shorter than those in the control group , and there were significant differences (both P<0.05). Conclusion The fiberoptic bronchoscopy combined with vibrating sputum excretion treatment can improve the respiratory function of the patients with aspiration pneumonia after radiotherapy for nasopharyngeal carcinoma, shorten the hospitalization time, and be beneficial to the prognosis of the patients.