纤维支气管镜吸痰灌洗治疗呼吸重症监护室肺部感染的临床分析

Clinical Analysis of Sputum Aspiration and Lavage with Fiberbronchoscope in Treatment of Pulmonary Infection in Respiratory Intensive Care Unit

目的探讨针对呼吸重症监护室(RICU)肺部感染患者应用纤维支气管镜吸痰灌洗治疗的临床效果。方法选择2021年7月-2022年12月期间RICU接收的108例肺部感染者作为研究对象,遵循随机数字表法分组原则,将患者分成观察组(n=54)与对照组(n=54)。对照组患者应用常规治疗方法,观察组患者应用常规治疗结合纤维支气管镜吸痰灌洗治疗,疗程为1周。对比两组的临床疗效,症状缓解情况,治疗前后的肺功能指标[第一秒用力呼气容积占预计值的百分比(FEV1%)与用力肺活量占预计值的百分比(FVC%)]变化,治疗前后的血气分析指标[血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)]变化。比较两组患者并发症发生情况。结果观察组的患者治疗总有效率为92.59%,对照组总有效率为74.07%,观察组高于对照组(P<0.05);观察组患者在体温恢复时间、肺啰音消失时间、血象改善时间、肺部病变吸收时间、住RICU时间均比对照组更短(P<0.05);两组患者治疗1周在FEV1%、FVC%、SaO2、PaO2指标水平均较治疗前有所提高,而观察组在治疗后指标均高于对照组,对比差异有统计学意义(P<0.05),两组治疗1周在PaCO2指标水平较治疗前降低,但观察组治疗后指标低于对照组,对比差异有统计学意义(P<0.05)。两组患者并发症发生率不存在统计学差异(P>0.05)。结论应用纤维支气管镜吸痰灌洗治疗RICU肺部感染,可取得良好效果,加速疾病转归,改善患者肺功能以及血气指标,并且不会增加并发症的发生。

Objective to explore the clinical effect of applying fiberoptic bronchoscopy sputum aspiration and lavage treatment for patients with lung infection in respiratory intensive care unit(RICU).Methods 108 cases of pulmonary infections received by RICU during July 2021-December 2022 were selected as the study subjects,and the patients were divided into the observed group(n=54)and the controlled group(n=54)following the principle of grouping by randomized numerical table method.The patients in the controlled group were treated with conventional treatment,and the patients in the observed group were treated with conventional treatment combined with fiberoptic bronchoscopic sputum aspiration and lavage,and the course of treatment was 1 week.The two groups were compared in terms of clinical efficacy,symptom relief,changes in pulmonary function indexes[first second expiratory volume with exertion as a percentage of the predicted value(FEV1%)and expiratory lung capacity as a percentage of the predicted value(FVC%)]before and after treatment,and changes in blood gas analytical indexes[oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2),and arterial partial pressure of carbon dioxide(PaCO2)]before and after treatment.Variation.Comparison of the occurrence of complications in the two groups of patients.Results The total effective rate of treatment of patients in the observation group was 92.59%,and the total effective rate of the control group was 74.07%,which was higher than that of the control group(P<0.05);the patients of the observation group had a shorter time for recovery of body temperature,disappearance of pulmonary rales,improvement of blood picture,absorption of lung lesions,and stay in the RICU than that of the control group(P<0.05);the patients of the two groups were treated for 1 week in FEV1%,FVC%,SaO2,PaO2 index level are improved compared with the pre-treatment,while the observation group in the post-treatment index are higher than the control group,the difference is statistically significant in comparison(P<0.05),the two groups in the treatment of 1 week in the level of PaCO2 index is reduced compared with the pre-treatment,but the observation group in the post-treatment index is lower than the control group,the difference is statistically significant in comparison(P<0.05).There is no statistical difference in the incidence of complications between the two groups(P>0.05).Conclusion the application of fiberoptic bronchoscopy sputum suction and lavage for the treatment of pulmonary infection in RICU can achieve good results,accelerate the regression of the disease,improve the patients'lung function as well as the index of blood gases,and will not increase the incidence of complications.