烧伤病人气管切开术后纤维支气管镜灌洗治疗的临床应用

Clinical application of fiberoptic bronchoscopy lavage in the treatment of burn patients after tracheotomy

目的：探讨重度烧伤病人气管切开术后经纤维支气管镜灌洗对防治肺部感染的临床效果。方法：将74例没有合并吸入性损伤的重度烧伤患者随机分为实验组（38例）与对照组（36例）。实验组在常规治疗基础上早期采用经纤维支气管镜灌洗，对照组仅予常规治疗，未予支气管灌洗。结果：实验组38例患者中18例出现肺部感染，14例感染控制，感染控制时间11．50±1.74d；时照组36例患者中26例出现肺部感染，11例感染控制，感染控制时间17．82±2．40d。两组感染率比较，实验组明显低于对照组，感染控制率比较，实验组明显高于对照组（P〈0．01），控制感染平均时间比较，实验组明显低于对照组（P〈0．01）。结论：经奸维支气管镜灌洗能有效防治重度烧伤后并发肺部感染，具有推广和应用价值。

Objective：To discuss the clinical effect of bronchoalveolar lavage by bronehoseopy for the prevention and treatment of pulmonary infection af-ter Tracheotomy in patients with severe burns. METHODS 75 severe burns patients without inhalation injury were randomly divided into experimental group （38 cases）and control group（36 eases）. Experimental group were early treated by the bronchoalveolar lavage on the basis of conventional therapy and the con-trol group were only treated by the conventional treatment but the bronchoalveolar lavage. RESULTS The 38 patients from experimental group, 18 patients had pulmonary infection, 14 cases of infection were controlled,the time of control was 11.50 ±1.74 days ; control group of 36 patients, 26 cases of lung infec-tion, 11 cases of infection were controlled,the time of control was 17.82±2.40 days. Compare the Infection rate of two groups,experimental group was signif-icantly lower than the Control group（P〈0. 01） ,infection control rate of experimental group was significantly higher than the control group. （P〈0. 01）. For average time of infection control, experimental group was significantly lower than the control group（P〈0.01）. CONCLUSION Bronchoalveolar lavage by bronchoscopy can effectively prevent pulmonary infection after severe burns with promotion and application value.