两种方法支气管肺泡灌洗安全性对比研究

Comparison of the Safety of Two Regimens for Bronchoalveolar Lavage

目的对比研究远端导管方法支气管肺泡灌洗和普通方法支气管肺泡灌洗的安全性,探讨提高支气管肺泡灌洗(BAL)安全性的新方法。方法随机选取2011年3月—2014年3月在该院肺病科(呼吸内科)住院患者作BAL病例60例,采用随机的方法 ,分为试验组给予远端导管方法 BAL和对照组给予普通方法 BAL,各30例,统计记录远端导管方法与普通方法 BAL过程中低氧血症、气道出血、心血管并发症和喉支气管痉挛、剧烈咳嗽等并发症,并研究比较两种方法 BAL的安全性。结果试验组与对照组低氧血症的发生例数分别为5例、13例,差异有统计学意义(P<0.05)。试验组与对照组气道出血的发生例数分别为:2例、14例,差异有统计学意义(P<0.05)。试验组与对照组心率增快发生例数分别为:1例、8例,差异有统计学意义(P<0.05)。试验组与对照组剧烈咳嗽发生例数分别为:2例、3例,差异有统计学意义(P<0.05)。试验组30例成功完成操作,对照组1例因严重低氧血症操作失败。两组均无喉支气管痉挛、严重心律失常、大咯血发生。结论远端导管方法 BAL较普通方法 BAL的并发症少、提高操作成功,增强了BAL的安全性。

Objective To compare the safety between bronchoalveolar lavage （BAL） with distal catheter and the convenliml- al BAL, and investigate the new way for improving the safety of BAL. Methods 60 inpatients underwenl BAI, in I）epartment of Pulmonary Disease （Department of Respiratory Medicine） from March 2011 to March 2014 were ramtomly divided into the experimental group and the control group with 30 cases in each, treated by BAL with distal catheter and the conventional BAL, respectively. The hypoxia, airway bleeding, cardiovascular complications, laryngeal spasm, severe cough and so on occurred during the BAL were counted and recorded. And the safety of the two methods for BAL was compared and studied. Results 5 cases in the experimental group and 13 cases in the control group had hypoxia, Ihe difference between the two groups was statistically significant（P〈O.05）. 2 cases in the experimental group and 14 cases in the control group had ai^wJay bleeding, the difference between the two groups was statistically significant （P〈O.05）. Increased heart rate occurred in 1 case in the experimental group and 8 cases in the cnntrol grnup with statistically significant difference between the two groups（P〈0.05）. Severe cough occurred in 2 cases in the experimental group and 3 cases in the control group with statistically significant difference between the two groups （P〈O.05）. The BAL was successfully performed in the 30 cases in the ex- perimental group, while it was failed in 1 case in the control group due to severe hypoxia. Both groups had no laryngeal spasm, severe arrhythmia and massive hemoptysis. Conclusion The complications of BAL with distal catheter were less and the suceessful rate of operation was higher, so the safety of BAL was enhanced.