早期床旁纤维支气管镜肺泡灌洗治疗显性吸入性肺炎致ARDS 29例临床分析

Clinical analysis of early bedside electronic bronchoscopic suction of sputum in the acute respiratory distress syndrome induced-dominant aspiration pneumonia

目的探讨在机械通气和加强抗感染的基础上应用纤维支气管镜肺泡灌洗治疗显性吸入性肺炎致急性呼吸窘迫综合征(ARDS)的早期临床疗效。方法将显性吸入性肺炎致ARDS的29例患者随机分为对照组和治疗组,对照组采用去除诱因、建立人工气道、机械通气、联合应用抗生素等综合治疗措施;治疗组在此基础上给予1～3次纤维支气管镜肺泡灌洗。结果治疗组PaO2和脉搏血氧饱和度(SpO2)的升高程度显著高于对照组(P<0.01);且治疗组PaCO2的下降程度显著低于对照组(P<0.01);治疗组胸片阴影消失平均时间、呼吸机平均使用时间和ICU内入住时间均明显少于对照组(P<0.01)。结论在机械通气和加强抗感染的基础上进行纤维支气管镜肺泡灌洗是治疗显性吸入性肺炎致ARDS的一种有效的辅助治疗措施,值得推广应用。

Objective To investigate the efficacy of electronic bronchoscopic suction of sputum in the acute respiratory distress syndrome（ARDS） induced-dominant aspiration pneumonia.Methods 29 patients were randomly divided into fiberoptic bronchoscope（FB） group and control group.The treatment of control group included getting rid of inducement,using antibiotics united,mechanical ventilation,and the FB group was treated with electronic bronchoscopic suction of sputum,sputum plugs,food debris,or mucus secretions except the other treatments above all.Results The PaO2 and SpO2 in FB group was higher than that of control group（P0.01）.Meanwhile,PaCO2 in FB group was lower than that of control group（P0.01）.Conclusion The treatment with electronic bronchoscopic suction of sputum in the ARDS induced-dominant aspiration pneumonia was one of feasible,effective and safe treatments.