支气管镜与无创呼吸机在呼吸衰竭患者诊断及治疗中的应用价值

The application value of bronchoscopy and noninvasive ventilator in the diagnosis and treatment of respiratory failure

目的探讨支气管镜与无创呼吸机在呼吸衰竭患者的诊断及治疗中的应用价值。方法选取2014年1月至2016年3月收治的146例呼吸衰竭患者进行诊断和治疗,根据诊断和治疗的方法不同分为治疗组和对照组,每组73例。2组患者均进行常规抗炎治疗,在此基础上,对照组经过支气管镜诊断并进行高频通气给氧治疗,治疗组经过支气管镜诊断并进行无创呼吸机治疗。观察2组患者临床效果、心率、血氧饱和度、二氧化碳分压及血清中的TNF-α,IL-6、IL-8水平及机械通气时间、住院时间。结果治疗组总有效率(97.3%)明显高于对照组(78.1%),差异有统计学意义(P<0.05);治疗组心率、血氧饱和度、二氧化碳分压与对照组比较,差异有统计学意义(P<0.05);治疗组血清中TNF-α、IL-6、IL-8水平明显低于对照组,差异有统计学意义(P<0.05);治疗组机械通气时间、住院时间明显少于对照组,差异有统计学意义(P<0.05)。结论经过支气管镜诊断并进行无创呼吸机治疗呼吸衰竭患者可以很好的改善患者的症状,降低炎性反应,缩短治疗时间,安全可靠。

Objective To investigate the application value of bronchoscopy and noninvasive ventilator in the diagnosis and treatment of respiratory failure .Methods One hundred and forty -six patients who were treated in our hospital from January 2014 to March 2016 were enrolled in the study .According to different methods of diagnosis and treatment , these patients were divided into observation and control group , with 73 patients in each group .The patients in both groups were treated by routine anti-inflammatory,moreover, the patients in control group ,on the basis of routine therapy , were treated by high frequency ventilation oxygen after bronchoscopy diagnosis ,however,the patients in observartion group,on the basis of routine therapy , were treated by noninvasive ventilator after bronchoscopy diagnosis .After treatment the therapeutic effects , heart rate, blood oxygen saturation , carbon dioxide partial pressure and serum levels of TNF-α, IL-6, IL-8, mechanical ventilation time and length of staying in hospital were observed and compared between two groups .Results The total effective rate in observation group was significantly higher than that in control group （97.3% vs 78.1%, P〈0.05）.There were significant differences in heart rate ,oxygen saturation and carbon dioxide partial pressure between two groups （ P〈0.05）. The serum levels of TNF-α,IL-6,IL-8 in observation group were significantly lower than those in control group （ P〈0.05）. Moreover , the mechanical ventilation duration and length of staying in hospital in observation group were significantly less than those in control group （ P〈0.05）.Conclusion The noninvasive ventilator can obviously improve the symptoms of patients with respiratory failure after bronchoscopy diagnosis , which can decrease inflammatory reaction , shorten treatment time , with safety and reliability .