支气管镜吸痰与肺泡灌洗对慢性阻塞性肺疾病并呼吸衰竭患者的疗效观察

Efficacy of bronchoscope suction and lavage on chronic obstructive pulmonary disease patients with respiratory failure

目的 观察支气管镜吸痰与肺泡灌洗对慢性阻塞性肺疾病（COPD）并呼吸衰竭患者的疗效.方法 选择2013年6月至2014年7月收治的62例COPD并呼吸衰竭患者,按照入院顺序将其分为观察组和对照组,每组31例.所有患者均给予常规对症治疗,对照组给予普通吸痰管治疗,观察组给予支气管镜吸痰治疗.观察两组患者治疗前后的血气指标,统计并比较两组患者肺部感染控制窗的出现时间、机械通气后需住院的时间、有创机械通气时间及呼吸衰竭所需的纠正时间.结果 治疗后,观察组机械通气后住院时间、有创机械通气时间、出现肺部感染控制窗的时间及呼吸衰竭纠正时间明显短于对照组,差异有统计学意义（P＜0.05）;治疗后,观察组动脉血氧分压、动脉血二氧化碳分压及动脉血氧饱和度改善情况显著优于对照组,差异有统计学意义（P＜0.05）.结论 COPD并呼吸衰竭患者应用支气管镜吸痰与肺泡灌洗可以明显控制感染,其疗效较好,值得推广使用.

Objective To observe the effects of bronchoscope suction and lavage on chronic obstructive pulmonary disease （COPD） patients with respiratory failure.Methods From June 2013 to July 2014,62 COPD patients with respiratory failure were selected according to the order of admission,and all the patients were divided into observation group and control group,with 31 cases in each group.All patients were treated with conventional symptomatic treatment,the patients in control group were treated by common suction pipe,and the patients in observation group were treated by bronchoscope suction.Blood gas indexes of two groups before and after treatment were observed,the emergence time of the lung infection control window,after mechanical ventilation requiring hospitalization time,invasive mechanical ventilation time and corrective time of respiratory failure of the two groups were compared.Results After treatment,the length of hospital stay after their mechanical ventilation,the time of invasive mechanical ventilation,the emergence time of the lung infection control window,breathing failure correcting time were significantly shorter than those of the control group,the differences were significant （P 〈 0.05）;The levels of PaO2,PaCO2 and SaO2 of observation group were significantly better than those of the control group,the differences were significant （P 〈 0.05）.Conclusions Bronchoscopic lavage and suction for COPD patients with respiratory failure can control the infection,and the efficacy is good,so is worthy of promotion.