CT导引下纤维支气管镜吸痰在COPD合并重症肺感染中的应用

APPLICATION OF CT-GUIDED BRONCHOSCOPY SPUTUM SUCTION IN COPD WITH SEVERE PNEUMONIA PATIENTS

目的探讨CT导引下纤维支气管镜吸痰在慢性阻塞性肺疾病(COPD)合并重症肺感染中的价值。方法将46例COPD合并重症肺感染患者随机分为二组,每组23例,观察组除常规给予有创呼吸机机械通气、抗生素、化痰、平喘、营养支持外,均采用CT导引下纤维支气管镜吸痰。对照组给予常规治疗而未使用纤支镜吸痰,将二组临床疗效、体温、白细胞计数及肺感染评分进行比较。结果二组治疗前酸碱度(pH)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、体温、白细胞计数及肺感染评分比较差异无统计学意义(P>0.05);治疗3d后观察组与对照组酸碱度(pH)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、体温、白细胞计数及肺感染评分比较差异有统计学意义(P<0.05)。结论 CT导引下纤维支气管镜吸痰可提高COPD合并重症肺感染患者的治愈率,是一种安全、简便、有效的方法,具有推广和应用的价值。

Objective To evaluate the significance of CT-guided bronchoscopy sputum suction value in COPD with severe pneumonia patients.Methods Forty-six COPD with severe pneumonia patients were randomly divided into treatment group and control group（n=23 for each group）.Patients in the treatment group were given invasive mechanical ventilation,antibiotics,eliminate sputum,relieving asthma,nutritional support and CT-guided bronchoscopy sputum suction.Patients of the control group were given routine therapy,but without fiberoptic bronchoscopy sputum suction.The clinical efficacy,body temperature,white blood cell count and clinical pulmonary infection score were compared between the two groups.Results There were no significant differences in acidity（pH）,arterial partial pressure of oxygen（PaO2）,arterial carbon dioxide tension（PaCO2）,body temperature,white blood cell count and clinical pulmonary infection score before treatment between the two groups（P〉 0.05）;There were differences in acidity（pH）,arterial partial pressure of oxygen（PaO2）,arterial carbon dioxide tension（PaCO2）,body temperature,white blood cell count and clinical pulmonary infection score at three days after treatment between the two groups（P〈0.05）.Conclusion The CTguided bronchoscopy sputum suction can improve the cure rate of the COPD with severe pneumonia patients,which is a safe,simple,and effective way,with the promotion and application value.