无创正压通气联合纤维支气管镜肺灌洗治疗重症肺部感染的临床研究

Clinical research on noninvasive positive pressure ventilation combined with fiberoptic bronchoscopy lavage for treatment of severe pulmonary infections

目的探讨无创正压通气联合纤维支气管镜肺灌洗治疗重症肺部感染的临床效果,为临床治疗提供参考依据。方法选取2011年4月-2013年3月重症肺部感染患者160例,随机分为两组,对照组76例患者实施单纯无创正压通气治疗,观察组84例患者实施无创正压通气联合纤维支气管镜肺灌洗治疗;对两组患者体温、白细胞计数、血气分析结果进行比较,对治疗效果进行评价,所有数据采用SPSS13.0软件进行分析。结果治疗后观察组患者体温、白细胞计数、PaO2、PaCO2和SaO2分别为(36.25±0.61)℃、(7.84±3.27)×109/L、(79.20±3.24)mm Hg、(36.48±4.38)mm Hg和(94.16±7.35)%,对照组患者分别为(37.62±0.73)℃、(11.85±4.36)×109/L、(65.64±3.52)mm Hg、(54.07±4.22)mm Hg和(89.79±6.23)%,两组患者均较治疗前有明显改善,且观察组患者更为明显;治疗显效率和总有效率观察组患者分别为64.29%和94.05%,对照组分别为51.32%和77.66%,观察组患者均明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论在无创正压通气的基础上联合纤维支气管镜肺灌洗治疗,可以有效提高重症肺部感染患者的治疗效果、改善患者预后。

OBJECTIVE To investigate clinical effect of noninvasive positive pressure ventilation combined with fiberoptic bronchoscopy lavage for treatment of severe pulmonary infections and provide reference for clinical treatment. METHODS Totally 160 patients with severe pulmonary infections were randomly divided into two groups, the control group （n= 76）, and the observation group （n= 84）. The control group received noninvasive positive pressure ventilation therapy alone, while the observation group received noninvasive positive pressure ventilation combined with fiberoptic bronchoscopy for lung lavage. Two groups were compared for body temperature, white blood cell count, and results of blood gas analysis. Results for the two groups of patients were evaluated and data were analyzed with SPSS 13.0. RESULTS After treatment, the patients body temperature, white blood cell count, PaO2 , PaCO2 and SaO2 were （36.25±0.61） ℃, （7.84±3.27） × 10^9/L, （79.20±3.24）mm Hg, （36.48±4.38） mm Hg and （94.16±7.35）%, respectively for patients in the observation group~ （37.62±0. 73） ℃, （11. 85±4.36） ×10^9/L, （65.64±3.52）mm Hg, （54. 07±4.22）mm Hg and （89.79±6.23）% for patients in the control group. Both groups had a significant improvement compared with before treatment, and the observation group had more obvious changes. The significant efficiency and the total effective rate was 64.29 % and 94.05 % in the observation group, significantly higher than 51.32%, 77.66% in the control group （P〈0.05）. CONCLUSION Noninvasive positive pressure ventilation on the basis of fiberoptie bronehoscopy for lung lavage can effectively improve the treatment of patients with severe pulmonary infections and the prognosis of patients.