纤维支气管镜吸痰联合肺泡灌洗在呼吸机相关性肺炎治疗中的应用

Sputum Suction and Alveolar Lavage Using Bronchofiberscope in Treatment of Ventilator-associated Pneumonia

目的分析纤维支气管镜吸痰联合肺泡灌洗在呼吸机相关性肺炎治疗中的应用效果。方法随机选取2014年1月—2015年1月间该院收治的90例呼吸机相关性肺炎(VAP)患者,随机分为观察组以及对照组,每组45例,对照组采用常规治疗,观察组在此基础上给予纤支镜联合肺泡灌洗治疗,比较两组患者的机械通气时间、ICU住院时间、住院费用,治疗有效率以及治疗前、治疗后1、4 h的PIP、Cdyn、Raw、WOB指标变化情况。结果治疗后1 h,观察组PIP、Cdyn、Raw指标改善程度均明显优于对照组,治疗后4 h,观察组PIP、Cdyn、Raw、WOB指标改善程度明显优于对照组,观察组治疗有效率为95.56%,对照组为75.56%,观察组患者的机械通气时间、住院天数以及住院费用均明显少于对照组,组间比较差异具有统计学意义,P<0.05。结论纤维支气管镜肺泡灌洗治疗应用于VAP患者能够起到确切的效果,能够有效控制肺部感染,改善呼吸力学参数。

objective To analyze the effect of sputum suction and alveolar lavage using bronchofiberscope in the treatment of ventilator-associated pneumonia(VAP). Methods 90 with VAP admitted to our hospital between January 2014 and January 2015 were randomized into the observation group or the control group with 45 in each one. The patients in the control group received conventional treatment based on which those in the observation group underwent sputum suction and alveolar lavage using bronchofiberscope. The duration of mechanical ventilation, ICU length of stay, hospitalization expenses, effective rate, as well as the changes of PIP, Cdyn, Raw, WOB before, 1h and 4h after the treatment were compared between the two groups. Results The improvements of PIP, Cdyn, Raw, WOB were better in the observation group than in the control group 1h after treatment, as well as those 4h after treatment; the effective rate was higher in the observation group than in the control group(95.56% vs 75.56%); statistically significant differences were found between the two groups regarding duration of mechanical ventilation, ICU length of stay, hospitalization expenses, P <0.05. Conclusion Sputum suction and alveolar lavage using bronchofiberscope in the treatment of VAP can control lung infection and improve the respiratory mechanics parameters with exact effect.