纤维支气管镜肺泡灌洗治疗急性呼吸窘迫综合征的临床疗效及对患者机械通气时间的影响

Clinical efficacy of fiberoptic bronchoscopic alveolar lavage in the treatment of acute respiratory distress syndrome and its effect on the duration of mechanical ventilation

目的探究纤维支气管镜肺泡灌洗治疗急性呼吸窘迫综合征(ARDS)的临床疗效及对患者机械通气时间的影响。方法选取2020年1月至2021年6月于本院接受纤维支气管镜肺泡灌洗、气管插管或气管切开的60例中、重度ARDS患者作为研究对象,依据随机数字表法分为对照组、观察组,每组30例。对照组行常规治疗,观察组行纤维支气管镜肺泡灌洗治疗,比较两组临床指标(呼吸机待机时间、机械通气时间、住院时间)、氧合指数[动脉血氧分压(PaO_(2))、动脉血氧分压与吸入气氧浓度的比值(PaO_(2)/FiO_(2))、动脉血二氧化碳分压(PaCO_(2))]及临床疗效。结果观察组呼吸机待机时间、机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组PaO_(2)、PaO_(2)/FiO_(2)、PaCO_(2)比较差异无统计学意义;治疗后,两组PaO_(2)、PaO_(2)/FiO_(2)水平均高于治疗前,PaCO_(2)水平均低于治疗前,且观察组PaO_(2)、PaO_(2)/FiO_(2)水平均高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为96.67%,高于对照组的80.00%,差异有统计学意义(P<0.05)。结论纤维支气管镜肺泡灌洗治疗ARDS效果确切,可明显改善患者氧合指标,缩短机械通气时间等临床指标,促进患者康复,值得临床推广应用。

Objective To investigate the clinical efficacy of fiberoptic bronchoscopic alveolar lavage in the treatment of acute respiratory distress syndrome(ARDS)and its effect on mechanical ventilation time of patient.Methods A total of 60 patients with moderate and severe ARDS who underwent endotracheal intubation or tracheostomy and received flexible bronchoscopic alveolar lavage therapy in our hospital from January 2020 to June 2021 were selected as the study subjects,and they were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group was treated with conventional treatment,and the observation group was treated with fiberoptic bronchoscopic alveolar lavage,and the clinical indicators(ventilator standby time,mechanical ventilation time,hospital stay),oxygenation index(arterial partial pressure of oxygen[PaO_(2)],ratio of partial pressure of arterial blood oxygen to inhaled oxygen concentration[PaO_(2)/FiO_(2)],partial pressure of arterial blood carbon dioxide[PaCO_(2)])and clinical efficacy were compared between the two groups.Results The rentilator standby time,mechanical ventilation time and hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences of PaO_(2),PaO_(2)/FiO_(2) and PaCO_(2) between the two groups;after treatment,the levels of PaO_(2) and PaO_(2)/FiO_(2) in the two groups were higher than before treatment,the levels of PaCO_(2) were lower than before treatment,and the levels of PaO_(2) and PaO_(2)/FiO_(2) in the observation group were higher than those in the control group,and the levels of PaCO_(2) were lower than those in the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the observation group was 96.67%,which was higher than 80.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Fiberoptic bronchoscopic alveolar lavage has definite effect in the treatment of ARDS,which can significantly improve the oxygenation index,shorten the time of mechanical ventilation and other clinical indicators,and promote the recovery of patients,which is worthy of clinical promotion and application.