纤维支气管镜吸痰联合肺泡灌洗对COPD合并呼吸衰竭的临床效果

Clinical effect of fiberoptic bronchoscopic sputum aspiration and bronchoalveolar lavage in COPD complicating respiratory failure

目的研究纤维支气管镜吸痰联合肺泡灌洗对慢性阻塞性肺疾病(COPD)并发呼吸衰竭的临床效果。方法选取2012年10月至2016年10月该院入院治疗的136例COPD并发呼吸衰竭患者,所有患者均为气管插管机械通气,随机分为对照组和观察组,每组各68例。在扩张气管、祛痰治疗、抗感染等常规治疗基础上,对照组患者采用普通的吸痰管吸痰,观察组采用纤维支气管镜吸痰联合肺泡灌洗,比较2组患者治疗前后的血液指标、血气分析指标、临床状况及治疗方案的临床总有效率。结果与治疗前比较,2组患者的降钙素原(PCT)、白细胞计数(WBC)等指标均有明显改善,且观察组改善幅度更为明显,差异有统计学意义(P<0.05)。与治疗前比较,2组患者的氧分压(PaO2)和血氧饱和度(SaO2)水平均明显升高,二氧化碳分压(PaCO2)水平明显降低,且观察组变化幅度大于对照组,差异有统计学意义(P<0.05)。观察组患者有创通气时间、呼吸衰竭纠正时间及住院时间均明显少于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为91.2%,明显高于对照组的75.0%,差异有统计学意义(P<0.05)。结论纤维支气管镜吸痰联合肺泡灌洗对于有创通气的COPD并发呼吸衰竭患者具有明显的临床治疗效果,可明显改善患者的血液及血气指标,缩短患者住院时间和有创通气,临床总有效率高于常规吸痰治疗,值得在临床中推广。

ObjectiveTo observe the clinical effect of fiberoptic bronchoscopic sputum aspiration combined with bronchoalveolar lavage in chronic obstructive pulmonary disease（COPD）complicating respiratory failure（RF）.MethodsTotally 136 inpatients with COPD complicating RF in this hospital from October 2012 to October 2016 were selected.All cases were performed the tracheal intubation for conducting mechanical ventilation and were randomly divided into the control group and observation group,68 cases in each group.On the basis of conventional treatment such as the tracheal expansion,expectorant treatment and anti infection,the control group adopted the sputum suction by adopting the common aspiration tube,while the observation group adopted fiberoptic bronchoscopic sputum aspiration combined with bronchoalveolar lavage.The blood indexes,blood gas analysis indexes and clinical status before and after treatment,and the total effective rate of clinical treatment scheme were compared between the two groups.ResultsTotally 136 inpatients with COPD complicating RF in this hospital from October 2012 to October 2016 were selected.All cases were performed the tracheal intubation for conducting mechanical ventilation and were randomly divided into the control group and observation group,68 cases in each group.On the basis of conventional treatment such as the tracheal expansion,expectorant treatment and anti infection,the control group adopted the sputum suction by adopting the common aspiration tube,while the observation group adopted fiberoptic bronchoscopic sputum aspiration combined with bronchoalveolar lavage.The blood indexes,blood gas analysis indexes and clinical status before and after treatment,and the total effective rate of clinical treatment scheme were compared between the two groups.ConclusionFiberoptic bronchoscope sputum aspiration combined with bronchoalveolar lavage has a significant clinical curative effect in the patients with COPD complicating RF,can significantly improve the blood and blood gas indexes,shortens the hospitalization time and invasive ventilation time,its total clinical effective rate is higher than that of conventional sputum suction treatment,which is worthy of clinical promotion.