纤维支气管镜肺泡灌洗改善危重症下呼吸道感染患者中的临床应用

Clinical Application of Fiberoptic Bronchoalveolar Lavage in the Treatment of Severe Lower Respiratory Tract Infections

目的:观察应用纤维支气管镜对危重症下呼吸道感染患者予以肺泡灌洗治疗的疗效。方法:将我院重症医学科收治的气管插管或气管切开的危重症下呼吸道感染患者56例随机分为纤维支气管镜肺泡灌洗治疗组及对照组,两组患者常规给予呼吸机辅助呼吸、抗感染、普通吸痰、化痰、营养支持以及原发病的治疗,治疗组在上述基础上予以纤维支气管镜肺泡灌洗治疗。结果:治疗组总有效率为89.29%,对照组总有效率为60.71%,两组比较差异有统计学意义(P<0.05);治疗组感染控制时间、ICU住院天数、平均机械通气时间明显优于对照组,两组比较有统计学意义(P<0.05);治疗组hs-CRP、PCT水平明显低于同期对照组,差异有统计学意义(P<0.05);治疗组APACHEⅡ评分也优于同期对照组,组间比较有统计学意义(P<0.05)。结论:纤维支气管镜肺泡灌洗治疗危重症下呼吸道感染患者有利于下呼吸道分泌物清除,提高临床治愈率,提高撤机成功率,降低住ICU时间。

Objective： To observe the curative effect of fiberoptic bronchoalveolar lavage in the treatment of critical patients with lower respiratory tract infection. Methods： Fifty-six patients with severe lower respiratory tract infection treated tracheal intubation or tracheotomy,who were admitted in the Department of intensive medicine of our hospital,were randomly divided into two groups： the fiberoptic bronchoalveolar lavage treatment group and the control group. The patients of the two groups were given routine treatment of ventilator assisted respiration,anti-infection,common sputum aspiration,phlegm elimination,nutritional support and treatment of primary disease. On the basis of the above treatment,the treatment group was treated with bronchoalveolar lavage. Results： The total effective rate of the treatment group was89. 29%; the total effective rate of the control group was 60. 71%. There was significant difference between the two groups（ P〈0. 05）. The control time of infection,the length of ICU hospital stay,and the average mechanical ventilation time in treatment group were also significantly better than those in the control group,and there was statistical significance between the two groups（ P〈0. 05）. The level of hs-CRP and PCT in treatment group were significantly lower than that in the control group,and the difference was statistically significant（ P〈0. 05）. The APACHE II score of the treatment group was also better than that of the control group,and there was statistical significance between the two groups（ P〈0. 05）. Conclusion： Fiberoptic bronchoalveolar lavage for the treatment of critically ill patients with lower respiratory tract infection is conducive to lower respiratory secretions clearance,improve the clinical cure rate,raise the success rate of weaning machine,and reduce the hospital stay in ICU.