纤维支气管镜在COPD呼吸衰竭的应用

Application of fiberoptic bronchoscopy in the treatment of COPD patients complicated with respiratory failure

目的观察纤维支气管镜吸痰联合肺泡灌洗对COPD并呼吸衰竭的临床效果。方法将40例因感染诱发呼吸衰竭的COPD患者随机分为治疗组和对照组,每组各20例,对照组常规抗感染、解痉、平喘、抗炎、祛痰、吸氧等治疗。治疗组在此基础上通过纤支镜吸痰、支气管肺泡灌洗。比较两组的呼吸衰竭纠正时间,感染控制时间,住院时间,插管率情况。结果治疗组在呼吸衰竭纠正时间,感染控制时间,住院时间,插管率均优于对照组,差异有统计学意义(P<0.05)。结论经纤支镜吸痰肺泡灌洗治疗COPD并呼吸衰竭,能促进痰液引流,更有效的改善通气,控制感染,减少气管插管及有创机械通气的机率,缩短住院时间,具有临床应用价值。

Objective To observe the clinical curative effect of bronchoscopy combined with alveolar lavage in the treatment of patients with chronic obstructive pulmonary disease （COPD） and respiratory failure. Methods 40 COPD patients complicated with re- spiratory failure were randomly and evenly divided into the treatment group and the control group. The control group was treated with anti- spasmodic, anti-asthmatic, anti-inflammatory, expectorant, and oxygen therapy. On the basis of the control group, the treatment group was treated with bronchoscopy suction and bronchoalveolar lavage. Infection control time, duration of hospital stay, and intubation rate were compared between the two groups. Results The improvement of correct time in respiratory failure, infection control time, duration of hospital stay, intubation rate was more pronounced in the treatment group than in the treatment group with statistical significance （ P 〈 0. 05 ）. Conclusion Bronchoscopy suction and bronchoalveolar lavage can promote mucus drainage, improve ventilation, control infec- tion, reduce the probability of endotracheal intubation and invasive mechanical ventilation, and shorten the duration of hospital stay in the treatment of COPD patients complicated with respiratory failure.