全身麻醉苏醒前纤支镜吸痰灌洗治疗多发性创伤患者肺部感染效果观察

Efficacy of general anesthesia before suctioning bronchoscopy lavage lung infections in patients with multiple trauma

目的观察在全身麻醉苏醒前对多发性创伤合并肺炎患者行纤支镜吸痰灌洗治疗的临床疗效。方法选取该院2010年～2012年ICU病房多发性创伤合并肺炎需要手术患者80例，ASA分级Ⅲ～Ⅳ，其中40例患者行全身麻醉苏醒前纤支镜吸痰灌洗治疗，对照组常规吸痰。分析比较两组血气分析、气道峰压的变化、体温、白细胞的数量及肺部x线表现变化以评价肺部感染控制情况。结果灌洗组在纤支镜治疗后动脉血氧分压、呼气末二氧化碳及气道峰压明显改善；与开始治疗时比较差异有显著性，P〈0．05；与对照组相同的时间点相比较差异有显著性，P〈0．05；灌洗组与对照组治疗前比较无差异，P〉0．05。1周后灌洗组显效21例，好转14例，有效率88％；对照组显效10例，好转16例，有效率65％，两组有效率比较，p〈o．05。结论全身麻醉苏醒前纤支镜吸痰灌洗术是治疗多发性创伤患者肺部感染的有效方法。

[ Objective ] To observe the clinical efficacy of general anesthesia in multiple trauma patients with pneumonia suction bronchoscopy lavage. [Methods ] In our hospital in 2010 - 2012 multiple trauma pneumonia 80 patients in ICU needed surgery, ASA grade III - IV, of which 40 patients underwent general anesthesia before bron- choscopy lavage suction, control group routine suctioning, two groups of blood gas analysis, changes in peak airway pressure, body temperature, the number of white blood cells and lung X-ray changes in the situation were analyze and compared in order to evaluate lung infection control. [ Results ] Bronchoscopic lavage group after treatment, blood pressure, end-tidal carbon dioxide, peak airway pressure were significantly improved; compared with the start of treatment there were significant differences, P 〈0.05; compared with the control group,at same point in time the difference was statistically significant, P 〈0.05, lavage before treatment and control groups showed no difference, P 〉 0.05. A week later lavage group were 21 cases, improved in 14 cases, efficiency 88%; control group, 10 cases, 16 cases improved, efficiency 65% efficiency compared two groups, P 〈0.05. [ Conclusion ] General anesthesia before suctioning bronchoscopy lavage treatment of multiple trauma patients is an effective method of pulmonary infection.