重型颅脑损伤致严重肺部感染者纤支镜支气管肺泡灌洗术应用研究

The clinical application of bronchoalveolar lavage by way of fibrobronchoscopy on patients with severe lung infection after severe brain injury

目的:探讨纤支镜支气管肺泡灌洗术对重型颅脑损伤致严重肺部感染者治疗的价值及安全性。方法:将入选病人,随机分治疗组与对照组,①治疗组病人观察其灌洗术治疗前、后的心率(HR)、氧饱和度(SpO2)、动脉氧分压(PaO2)、二氧化碳分压PaCO2变化。②治疗组与对照组治疗结束进行疗效分析;两组均从机械通气时间、发热平均时间、肺部啰音消失时间、用抗生素时间等方面对比分析;并对治愈率、死亡率的进行对比分析??果:治疗组27例,术程均顺利,无并发症。术后HR、SpO2、PaO2明显好转(P<0.05),机械通气时间、发热平均时间及肺部啰音持续时间明显缩短,治疗组与对照组在机械通气时间、肺部啰音持续时间、治愈率、死亡率对比均有显著性差异(P<0.05)。结论:纤支镜支气管肺泡灌洗术,对重型颅脑损伤致严重肺部感染者,治疗效果好,安全性高,值得进一步推广应用。

Objective： To investigate the value and safety of bronchoalveolar lavage for serious lung infections caused by severe brain injury. Methods： The selected patients were randomly divided into treatment group and control group.①We observe the heart rate （HR）, oxygen saturation （SpaO2）,arterial partial pressure of oxygen （PaO2）, and changes in carbon dioxide partial pressure PaCO2 of patient with the bronchoalveolar lavage in pre and post therapy .②We analyze the curative effect of two grope from the mechanical ventilation time, the average time of fever, pulmonary tale disappearance time, antibiotics and the cure rate, mortality in the end of treatment. Results： Patients without any complication in treatment group.There are significant difference in HR, SpaO2 and PaO2 of patients in pre and post treatment（P〈0.05）.The patients＇ mechanical ventilation time, average time of fever and pulmonary rale is significantly shorter after therapy.The mechanical ventilation and pulmonary rale time of patients, cure and mortality rate in treatment group was shorter or lower than that of control group,and the difference was significant（P〈0.05）. Conclusion： bronchoalveolar lavage for severe lung infection caused by serious brain injury is effective and safety, it is worth to popularizing.