脑卒中患者气管切开前行纤维支气管镜治疗的临床必要性分析

Clinical Necessity Analysis of Fiberoptic Bronchoscopy Treatment before Tracheotomy in Patients with Stroke

目的:探讨脑卒中患者气管切开前行纤维支气管镜(简称纤支镜)治疗的临床效果。方法:选择2021年3月—2022年8月莆田学院附属医院收治的85例脑卒中患者作为研究对象,采用随机数表法将患者分为试验组(n=43)与对照组(n=42)。两组患者均采用气管切开治疗,对照组气管切开前行常规吸痰处理,试验组气管切开前行纤支镜气道分泌物清理。比较两组肺部感染发生率、时间相关指标及炎症相关指标。结果:试验组气管切开后第3天、7天肺部感染发生率低于对照组,差异有统计学意义(P<0.05);试验组重症监护时间、机械通气时间、全身炎症反应综合征(SIRS)持续时间短于对照组,差异有统计学意义(P<0.05);试验组气管切开后白细胞计数、降钙素原、C反应蛋白、内毒素水平低于对照组,差异有统计学意义(P<0.05)。结论:脑卒中患者气管切开前行纤支镜气道分泌物清理治疗对降低肺部感染发生率有积极作用,对缩短患者机械通气时间及重症监护时间、改善患者体内炎症反应亦有良好效果。

Objective:To study the clinical effect of fiberoptic bronchoscope(bronchoscopic)before tracheotomy in patients with stroke.Method:A total of 85 patients with stroke who admitted to Affiliated Hospital of Putian University from March 2021 to August 2022 were selected as the research objects,and they were divided into the test group(n=43)and the control group(n=42)by the random number table.The patients in both groups were treated by tracheotomy,the control group was given routine sputum suction before tracheotomy,and the test group was given bronchoscopic airway secretion cleaning before tracheotomy.The incidence of pulmonary infection,time related indexes and inflammatory related indexes were compared between two groups.Result:The incidence of pulmonary infection on the 3rd and 7th days after tracheotomy in the test group were lower than those in the control group,the differences were statistically significant(P<0.05).The duration of intensive care,mechanical ventilation and systemic inflammatory response syndrome(SIRS)in the test group were shorter than those in the control group,the differences were statistically significant(P<0.05).The leukocyte count,procalcitonin,C-reactive protein and endotoxin levels in the test group after tracheotomy were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Bronchoscopic airway secretion cleaning before tracheotomy in patients with stroke has a positive effect on reducing the incidence of pulmonary infection,shortening the time of mechanical ventilation and intensive care,and improving the inflammatory reaction in patients.