纤维支气管镜吸痰对气管插管患者术后肺部感染的影响

Effect of sputum suction by fiberoptic bronchoscopyon on postoperative pulmonary infections in patients undergoing tracheal intubation

目的观察并比较纤维支气管镜吸痰与普通吸痰管吸痰对气管插管患者肺部感染的预防和治疗作用,以降低肺部感染率。方法选取2008年1月1日-2011年7月31日行气管插管维持机械通气手术的患者164例,随机分为观察组85例和对照组79例,分别采用纤维支气管镜床边吸痰和普通吸痰管吸痰,入院前感染的患者均给予抗菌药物治疗;术后观察患者肺部啰音、X线胸片、痰细菌培养、体温和白细胞计数等,判定患者是否发生肺部感染,比较两组的肺部感染率。结果观察组和对照组的总有效率分别为85.29%和66.67%,观察组明显高于对照组,且两组比较差异有统计学意义(P<0.05);观察组和对照组肺部感染率分别为5.88%和19.23%,观察组明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论纤维支气管镜吸痰不仅可以有效治疗气管插管患者合并肺部感染,并对无肺部感染的患者可以明显降低感染率,疗效优于普通吸痰管。

OBJECTIVE To investigate and compare the effect of the sputum suction by fiberoptic bronchoscopy or normal sputum suction tube on the prevention and treatment of the pulmonary infections in the patients undergoing tracheal intubation so as to reduce the incidence of pulmonary infections.METHODS A total of 164 cases of patients who underwent the endotracheal intubation mechanical ventilation surgery from Jan 1,2008 to Jul 31,2011 were enrolled in the study and were randomly divided into the observation group with 85 cases and the control group with 79 cases.The observation group was treated with the bronchoscopy bedside suctioning,and the control was given the ordinary suction tube suctioning,the patients who were infected before the admission were treated with the antibiotics;The pulmonary rales,X-ray,sputum culture,body temperature,and white blood cell count were observed after the surgery to determine whether the pulmonary infections occurred,the incidence of the pulmonary infections was compared between the two groups.RESULTS The total effective rate of the observation group was 85.29%,significantly higher than 66.67% of the control group,the difference was statistically significant.The incidence rate of the pulmonary infections in the observation group was 5.88%,significantly lower than 19.23% in the control group,the difference was statistically significant（P0.05）.CONCLUSION The sputum suction by fiberoptic bronchoscopy can not only effectively treat the pulmonary infections in the patients undergoing the tracheal intubation but also significantly reduce the incidence of infections in the patients without pulmonary infections,the effect is superior to the ordinary sputum suction tube.