纤维支气管镜吸痰灌洗联合雾化吸入治疗慢性阻塞性肺病急性加重期的临床疗效

Clinical effect of fiberoptic bronchoscopy sputum suction and lavage combined with atomization inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨纤维支气管镜吸痰灌洗联合雾化吸入治疗慢性阻塞性肺病急性加重期(AECOPD)的临床疗效。方法选取2017年1月至2019年1月于北京丰台医院就诊的62例AECOPD患者作为研究对象,按照随机数字法分为观察组与对照组,每组31例。对照组给予常规吸引器吸痰治疗,观察组给予纤维支气管镜吸痰和灌洗治疗,比较两组临床疗效、血气分析[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SPO_(2))]及肺功能[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、用力肺活量(FVC)]指标。结果观察组治疗总有效率为93.5%,高于对照组的74.2%,差异有统计学意义(P<0.05)。治疗后,两组PaO_(2)、SPO_(2)指标高于治疗前,PaCO_(2)指标低于治疗前,且观察组PaO_(2)、SPO_(2)指标高于对照组,PaCO_(2)指标低于对照前,差异有统计学意义(P<0.05)。治疗后,两组FEV_(1)、FVC指标大于治疗前,PEF高于治疗前,且观察组组FEV_(1)、FVC指标大于对照组,PEF高于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜联合雾化吸入治疗AECOPD疗效显著,能快速清除气道内的分泌物及小气道中的栓塞,改善患者的通气功能,减轻气道炎症反应,值得临床推广应用。

Objective To investigate the clinical effect of fiberoptic bronchoscopy sputum suction and lavage combined with atomization inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 62 AECOPD patients treated in Beijing Fengtai Hospital from January 2017 to January 2019 were selected as the research subjects,they were divided into observation group and control group according to the random number method,with 31 cases in each group.The control group was treated with conventional suction device,and the observation group was treated with fiberoptic bronchoscopy sputum suction and lavage.The clinical efficacy,blood gas analysis(partial pressure of oxygen[PaO_(2)],partial pressure of carbon dioxide[PaCO_(2)]and oxygen saturation[SPO_(2)])were compared between the two groups and lung function(one second to forced vital capacity[FEV_(1)],peak expiratory flow[PEF],forced vital capacity[FVC])indicators.Results The total effective rate of the observation group was 93.5%,which was higher than 74.2%of the control group,and the difference was statistically significant(P<0.05).After treatment,the PaO_(2) and SPO_(2) indexes of the two groups were higher than those before treatment,and the PaCO_(2) indexes were lower than those before treatment,and the PaO_(2) and SPO_(2) indexes of the observation group were higher than those of the control group,and the PaCO_(2) indexes were lower than those before the control,the differences were statistically significant(P<0.05).After treatment,FEV_(1) and FVC indexes of the two groups were higher than those before treatment,and PEF was higher than that before treatment,and FEV_(1) and FVC indexes of the observation group were higher than those of the control group,and PEF was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion Fiberoptic bronchoscopy combined with aerosol inhalation is effective in the treatment of AECOPD,which can quickly remove secretions in the airway and embolism in the small airway,improve the ventilation function of patients,and reduce airway inflammation,which is worthy of clinical promotion and application.