胸部物理治疗联合纤维支气管镜灌洗对肺结核的效果

Therapeutic effect of chest physiotherapy combined with fiberoptic bronchoscopy lavage on pulmonary tuberculosis

目的:探讨胸部物理治疗(CPT)联合纤维支气管镜(FB)灌洗对肺结核(PTB)患者的应用效果。方法:125例PTB患者根据随机数字表法分为对照组62例和观察组63例,对照组行常规治疗,观察组在其基础上行CPT联合FB灌洗。比较两组治疗7 d后排痰效果和治疗24 h后日排痰量;治疗前和治疗24 h后呼吸频率(RR)、血氧饱和度(SpO2)、气道峰压(PIP)、平均动脉压(MAP)、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(OI)。结果:与对照组比较,观察组排痰总有效率、日排痰量显著升高,差异有统计学意义(P<0.05);与治疗前比较,治疗后两组RR、PIP、MAP、PaCO_(2)显著降低,SpO2、PaO_(2)、OI显著升高,观察组变化幅度显著大于对照组(P<0.05)。结论:CPT联合FB灌洗对PTB患者有较好的应用效果,能够有效改善排痰效果和呼吸功能。

Objective To explore the therapeutic effect of chest physiotherapy(CPT)combined with fiberoptic bronchoscopy(FB)lavage in patients with pulmonary tuberculosis(PTB).Methods A total of 125 patients with PTB were randomly divided into control group(62 cases)and observation group(63 cases).The patients in control group received conventional treatment,while those in observation group were treated by conventional treatment and CPT combined with FB lavage.The sputum excretion after 7 days of treatment and the sputum volume at 24 hours after treatment were compared between two groups.Moreover,the changes of several indexes before and at 24 hours after treatment were also compared,and the indexes included respiratory rate(RR),oxygen saturation(SpO2),peak inspiratory pressure(PIP),mean arterial pressure(MAP),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))and oxygenation index(OI).Results The total effective rate of sputum excretion and the daily sputum volume in observation group were significantly higher and larger than those in control group,with statistical differences(P<0.05).After treatment,the RR,PIP,MAP and PaCO_(2) of both two groups were significantly decreased,and SpO2,PaO_(2),OI were significantly increased;and the changes of observation group were significantly greater than those of control group(P<0.05).Conclusion CPT combined with FB lavage has a good therapeutic effect on PTB,and it can facilitate sputum excretion and improve respiratory function effectively.