经纤维支气管镜吸痰及肺泡灌洗在机械通气患者中的应用

目的 探讨经纤维支气管镜(简称纤支镜)吸痰及灌洗在机械通气患者中的临床应用价值.方法 60例机械通气患者随机分为对照组和治疗组各30例.两组均给予抗感染及营养支持等治疗.对照组予常规吸痰治疗,治疗组予经纤支镜吸痰和灌洗治疗,观察比较两组患者治疗前后的临床疗效.结果 治疗组血气分析变化、机械通气时间及平均住院时间均优于对照组(均P ＜0.05)；治疗组成功脱机、器官衰竭及院内死亡例数均少于对照组(均P ＜0.05)；治疗组治愈率86.7％,高于对照组的60.0％(x2=2.60,P＜0.05).结论 机械通气患者行纤支镜吸痰及肺泡灌洗可提高机械通气患者脱机的成功率,减少住院病死率,是安全、有效的方法,值得临床推广.

Application of fiberoptic bronchoscopy with bronchoalveolar lavage in patients with mechanical ventilation

Objective To explore the clinical application of fiberoptic bronchoscopy with bronchoalveolar lavage（BAL） in patients with mechanical ventilation. Methods Sixty patients with mechanical ventilation were randomly divided into control group（ n = 30） and treatment group（ n = 30）. All patients accepted anti-infection, nutritional support treatments. The patients in the control group accepted routine treatment; others in the treatment group were treated with BAL. The therapeutic effects in the two groups were evaluated and compared. Results The treatment effects in treatment group was better than that in control group （ P 〈 0.05 ）. The improvement of blood gas analysis in treatment group was better than in control group （P 〈 0.05 ）, the time of mechanical ventilation,length of stay in treatment group were shorter than those in the control group （ P 〈 0.05 ）. The number of success to remove ventilator, organs failure and hospital mortality in treatment group were less than those in the control group （ P 〈 0. 05 ）. Conclusion Fiberoptic bronchoscopy with BAL treatment could be safe and effective for patients with mechanical ventilation. It deserves to be popularized.