纤维支气管镜肺泡灌洗对ICU老年重症肺炎患者血气水平的影响

Effect of bronchoalveolar lavage with fiberoptic bronchoscope on blood gas level of elderly patients with severe pneumonia in ICU

目的 探索纤维支气管镜肺泡灌洗对重症加强护理病房 (ICU) 老年重症肺炎患者血气水平的影响。方法 80 例 ICU 老年重症肺炎患者为研究对象,以简单随机化法分为对照组和实验组,每组 40 例。对照组给予规范常规治疗,实验组应用纤维支气管镜肺泡灌洗治疗。比较两组治疗效果、治疗前后血气[动脉血二氧化碳分压 (Pa CO_(2))、动脉血氧分压 (Pa O_(2))、氧合指数 (Pa O_(2)/Fi O_(2))]水平、不良反应发生情况。结果 实验组治疗总有效率 97.50% 高于对照组的 80.00%,差异具有统计学意义 (P<0.05)。治疗后,两组 Pa CO_(2)低于本组治疗前,Pa O_(2)、Pa O_(2)/Fi O_(2)高于本组治疗前,且实验组 Pa CO_(2)(32.50±4.30)mm Hg(1 mm Hg=0.133 k Pa) 低 于 对 照 组 的 (40.30±4.50)mm Hg,Pa O_(2)(93.50±5.50)mm Hg、Pa O_(2)/Fi O_(2)(374.50±22.50)mm Hg 高于对照组的 (80.20±6.20)、(340.50±26.30)mm Hg,差异均具有统计学意义 (P<0.05)。两组不良反应发生率比较,差异无统计学意义 (P>0.05)。结论 对 ICU 老年重症肺炎患者实施纤维支气管镜肺泡灌洗治疗方案能够有效提高临床治疗效果,改善血气水平,并且治疗安全性高,值得推广。

Objective To investigate the effect of bronchoalveolar lavage with fiberoptic bronchoscope on blood gas level of elderly patients with severe pneumonia in intensive care unit(ICU).Methods A total of 80 elderly patients with severe pneumonia in the ICU were selected as the research subjects,and were divided into control group and experimental group by simple randomization,with 40 cases in each group.The control group was treated with standard conventional treatment,while the experimental group was treated with bronchoalveolar lavage with fiberoptic bronchoscopy.Both groups were compared in terms of therapeutic effect,blood gas[arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),oxygenation index(PaO_(2)/FiO_(2))]levels before and after treatment,and occurrence of adverse reactions.Results The total effective rate 97.50%of the experimental group was higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).After treatment,the PaCO_(2) in the two groups was lower than that before treatment in this group,and the PaO_(2) and PaO_(2)/FiO_(2) were higher than those before treatment in this group;the PaCO_(2)(32.50±4.30)mm Hg in the experimental group was lower than(40.30±4.50)mm Hg(1 mm Hg=0.133 kPa)in the control group,and the PaO_(2)(93.50±5.50)mm Hg and PaO_(2)/FiO_(2)(374.50±22.50)were higher than(80.20±6.20)and(340.50±26.30)mm Hg in the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Bronchoalveolar lavage with fiberoptic bronchoscope for elderly patients with severe pneumonia in the ICU can effectively improve the clinical effect and blood gas levels,and has high treatment safety,which is worthy of promotion.