纤维支气管镜在慢性阻塞性肺疾病呼吸衰竭治疗中的应用研究

Fiberoptic bronchoscopy in treatment of chronic obstructive pulmonary disease induced respiratory failure

目的探讨纤维支气管镜(纤支镜)在慢性阻塞性肺疾病(COPD)呼吸衰竭治疗中的应用价值。方法选择382例经常规吸氧、抗感染、解痉平喘、化痰止咳或人工通气治疗效果不佳,具有痰液阻塞的COPD呼吸衰竭患者进行纤支镜吸痰、支气管灌洗及局部抗感染治疗。结果显效261例(68.3%),有效91例(23.8%),总有效率为92.1%,无效30例(7.9%)。结论对于分泌物较多难以排出气道的COPD呼吸衰竭患者,及时给予纤支镜吸引和灌洗,有利于迅速解除气道阻塞,改善血气交换。支气管吸引灌洗技术是一种安全有效、简便经济,易被患者接受的治疗方法。

Objective To investigate the effieaey of therapeutical approaehes via fiberoptie hronchoseopy （FB） in treatment of chronic obstructive pulmonary disease （COPD） induced respiratory failure. Methods 382 patients who were not fully, respousive to routine therapy （oxygen supplementation,antimicrobial, bronehodilation,mueolytics and ventilation） were nrolled. Secretion aspiration, hronchial washing and lavage, and topical use of antibioties via fiberoptie bronechoseopy were performed.Results The FB-based therapy demonstrated an improvement rate of 68.3%（261 cases）,an effective rate of 23.8% （91 cases）,and a total effective rate of 92.1%,but ineffective in 30 cases （7.9%）.Conelusion To patients with chronic obstructive pulmonary disease iuduced respiratory failure whose airways were obstacled by mucoid seeretion,bronchial washing and lavage via FB is a convenient and effective approach.