床旁纤支镜在COPD合并呼吸机相关肺炎患者中的疗效研究

Clinical Study of Bedside Fiberoptic Bronchoscopy in Patients with COPD Complicated with Ventilator-Associated Pneumonia

目的探究床旁纤支镜在COPD合并呼吸机相关肺炎患者中的疗效。方法选取2016年1月至2017年1月在我院接受治疗的COPD合并呼吸机相关肺炎患者84例,按照随机数表法分为观察组和对照组,对照组进行常规吸痰管吸痰,观察组进行常规吸痰管吸痰联合床旁纤支镜治疗,观察两组患者治疗的临床效果和肺部感染率评分。结果观察组患者治疗后第1天肺部感染评分为(7.0±1.2)分,对照组患者为(7.3±1.4)分,治疗后第2天观察组患者感染评分为(5.8±0.6)分,对照组患者为(6.7±0.9)分;治疗后第3天观察组患者感染评分为(3.6±0.4)分,对照组患者为(6.3±0.7)分,差异具有统计学意义,P<0.05;观察组患者治疗总有效率为85.72%,对照组患者治疗总有效率为57.14%,差异具有统计学意义,P<0.05;观察组患者治疗后并发症发生率为19.04%,对照组患者为38.09%,差异具有统计学意义,P<0.05。结论床旁纤支镜对治疗COPD合并呼吸机相关肺炎安全有效,能够降低患者治疗后并发症发生率,提高患者生存质量,值得临床推广使用。

Objective： To investigate the efficacy of bedside fiberoptic bronchoscopy in patients with COPD complicated with ventilator-associated pneumonia. Methods： From January 2016 to January 2017, 84 patients with COPD complicated with ventilator-associated pneumonia who were treated in our hospital were divided into observation group and control group according to the random number table method, and the control group was performed conventional suction tube suction. The observation group was treated with conventional suction tube suction combined with bedside fiberoptic bronchoscopy. The clinical effects and lung infection score of the two groups were observed. Results： In the observation group, the lung infection score was （7.0 ± 1.2） on the first day after treatment and （7.3 ±1.4） on the control group. The infection score in the observation group was （5.8 ± 0.6） on the second day after treatment （6.7 ±0.9） in the control group. The score of infection in observation group was （3.6 ±0.4） on the third day after treatment, and （6.3 ± 0.7） in the control group, the difference was statistically significant, P 〈0.05 ; The total effective rate was 85.72% in the observation group and 57.14% in the control group, the difference was statistically significant （P 〈0.05）; the incidence of postoperative complications was 19.04% in the observation group and 38.09%, the difference was statistically significant, P 〈0.05. Conclusion： The bedside fiberoptic bronchoscopy is safe and effective in the treatment of COPD with ventilatorassociated pneumonia. It can reduce the incidence of postoperative complications and improve the quality of life of patients, and is worthy of clinical promotion.