急性重症肺部感染合并肺不张老年患者应用纤维支气管镜治疗的评价

Evaluation of fiber bronchoscope in treating elderly patients with acute severelung infection and pulmonary atelectasis

目的探讨急性重症肺部感染合并肺不张老年患者使用纤维支气管镜治疗的临床效果及应用评价。方法选取2012年6月-2013年12月医院ICU收治的老年急性重症肺部感染合并肺不张患者80例,按数学随机方法平均分为常规组和治疗组,常规组实施内科常规治疗,治疗组实施纤维支气管镜吸痰以及支气管肺泡冲洗术,对比两组患者治疗效果、血氧分压(PaO2)等临床指标,数据采用SPSS 13.0统计软件分析,计量资料采用t检验,率的比较采用χ2检验。结果治疗有效率常规组为60.00%,治疗组为82.50%,两组对比差异有统计学意义(χ2=9.218,P<0.05);治疗组PaO2、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)、pH值,分别为(81.32±0.84)mm Hg、(43.28±0.92)mm Hg、(93.22±1.34)%、7.37±0.06,均优于常规组的(54.92±1.21)mm Hg、(58.21±1.03)mm Hg、(80.34±0.97)%、7.22±0.03,差异有统计学意义(P<0.05)。结论针对老年急性重症肺部感染合并肺不张患者,使用纤维支气管镜治疗临床效果显著确切,值得临床推广应用。

OBJECTIVE To investigate clinical effect and application evaluation of fiber bronchoscope therapy in elderly patients with acute severe pulmonary infection and pulmonary atelectasis. METHODS A total of 80 eases of elderly ICU patients with acute severe pulmonary infection and pulmonary atelectasis were selected from Jun. 2012 to Dec. 2013. They were randomly divided into conventional group and treatment group, and the conventional group implemented routine medical treatment, the treatment group was treated with fiber bronchoscope to suction the sputum and bronchoalveolar lavage, compared the two groups of the therapeutic effect , blood oxygen（PaO2 ） and other clinical indicators. SPSS 13.0 was adopted for analysis and the measurement data were examined by t-test. Rate comparison was examined by X2. RESULTS The effective rate in the conventional group was 60.00 %, and was 82.5 % in the treatment group. The difference was significant （X2 = 9. 218, P〈0.05）. The PaOz , partial pressure of carbon dioxide（PaCO2 ）, oxyhemoglobin saturation （SaOz）and pH value were（81.32±0.84）ram Hg, （43.28±0. 92）mm Hg, （93.22±1. 34）%, and 7.37!0.06 respectively in the conventional group, which were （54.92±1.21）ram Hg,（58.21＋1.03）mm Hg, （80. 344±0.97）%, and 7.22±0.03 in the treatment group. The difference was significant（P〈0.05）. CONCLUSIONS For elderly patients with acute severe pulmonary infection combined with pulmonary atelectasis, fiber bronchoscope has obvious clinical effect and is worthy of clinical application.