纤维支气管镜局部灌洗治疗脑卒中相关性肺炎的疗效观察

Observation on the effect of local lavage under fiberoptic bronchoscope in the treatment of strokerelated pneumonia

目的探讨对脑卒中相关性肺炎患者实施纤维支气管镜局部灌洗治疗的临床效果。方法80例脑卒中相关性肺炎患者,随机分为对照组和研究组,各40例。对照组采用开放式改良吸痰法治疗,研究组实施纤维支气管镜局部灌洗治疗。对比两组血气分析指标、炎性指标及胸部阴影吸收50%时间。结果研究组二氧化碳分压(42.02±5.42)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(60.39±4.74)mm Hg,氧分压(82.25±4.57)mm Hg、氧合指数(217±24)mm Hg、pH值(7.44±0.25)、动脉血氧饱和度(93.16±2.99)%均高于对照组的(68.57±5.30)mm Hg、(186±29)mm Hg、(7.28±0.26)、(85.26±3.25)%,差异有统计学意义(P<0.05)。研究组C反应蛋白、降钙素原、白细胞计数均低于对照组,差异有统计学意义(P<0.05)。研究组胸部阴影吸收50%时间(10.15±2.56)d短于对照组的(12.56±2.65)d,差异有统计学意义(P<0.05)。结论对脑卒中相关性肺炎患者实施纤维支气管镜局部灌洗治疗的效果确切,可对肺内感染进行控制,促进胸部阴影吸收。

Objective To discuss the clinical effect of local lavage under fiberoptic bronchoscope in the treatment of stroke-related pneumonia.Methods A total of 80 patients with stroke-related pneumonia were randomly divided into control group and research group,with 40 cases in each group.The control group was treated with open improved sputum suction method,and the research group was treated with local lavage under fiberoptic bronchoscope.The blood gas analysis indexes,inflammatory indexes and the time of 50%absorption of chest shadow were compared between the two groups.Results The partial pressure of carbon dioxide(42.02±5.42)mm Hg(1 mm Hg=0.133 kPa)of the research group was lower than(60.39±4.74)mm Hg of the control group,and partial pressure of oxygen(82.25±4.57)mm Hg,oxygenation index(217±24)mm Hg,pH value(7.44±0.25),arterial oxygen saturation(93.16±2.99)%were higher than(68.57±5.30)mm Hg,(186±29)mm Hg,(7.28±0.26)and(85.26±3.25)%of the control group,and the difference was statistically significant(P<0.05).The C-reactive protein,procalcitonin,white blood cell count of the research group were lower than those of the control group,and the difference was statistically significant(P<0.05).The time of 50%absorption of chest shadow(10.15±2.56)d of the research group was shorter than(12.56±2.65)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Local lavage under fiberoptic bronchoscope has affirmative efficacy for patients with stroke-related pneumonia,which can control lung infection and promote the absorption of chest shadows.