85例机械振动排痰联合纤维支气管镜治疗重症肺炎的临床分析

Clinical analyzed on the treatment of 85 cases patients with severe pneumonia by vibration sputum drainage combined with fiberoptic bronchoscope

目的分析针对重症肺炎患者,应用机械振动排痰联合纤维支气管镜吸痰治疗的效果。方法选择2013年1月—2017年12月本院呼吸内科收治的重症肺炎患者85例作为研究对象,随机分为对照组和观察组两组,对照组(37例)实施常规纤维支气管镜治疗,观察组(38例)实施机械振动排痰联合纤维支气管镜吸痰治疗,对比两组患者治疗前后的呼吸功能指标、炎性指标及临床疗效和预后等情况。结果治疗后,两组患者呼吸功能指标动脉氧分压(PaO2)和氧合指数(PaO2/FiO2)、动态顺应性(Cdyn)均显著上升,观察组显著高于对照组(P<0.05),气道阻力(Raw)明显下降,观察组显著低于对照组(P<0.05)。两组患者白细胞(WBC)、C反应蛋白(CRP)以及血降钙素原(PCT)等炎性指标均显著降低,观察组明显低于对照组(P<0.05)。观察组患者的治疗效果提高明显,机械通气时间、重症监护室住院时间、首次撤机成功率,改善幅度更大,差异显著(P<0.05)。结论重症肺炎患者,应用机械振动排痰联合纤维支气管镜吸痰,有明显的治疗效果,可以改善呼吸功能,降低感染指标,缩短机械通气时间,有助于患者的康复,达到显著的治疗效果。

Objective To investigate the curative effect of vibration sputum drainage combined with fiberoptic bronchoscope in the treatment of severe pneumonia patients.Methods 85 cases severe pneumonia patients got therapy in Xinxiang central hospital from January 2013 to December 2017 were selected,and they were divided into control group and observation group according to random number table.The patients in the control group received fiberoptic bronchoscope alone,and those in the observation group received fiberoptic bronchoscope combined with vibration sputum drainage.The respiratory function and inflammation index,curative effect,and prognosis after treatment were compared between these two groups.Results After treatment,the parameters were improved in both groups.Moreover,arterial oxygen pressure(PaO2),arterial oxygen saturation(SaO2),oxygenation index(PaO2/FiO2),dynamic compliance(Cdyn)in observation group were significantly higher than those of control group(P<0.05).Meanwhile,airway resistance(Raw)was significantly lower than that of the control group(P<0.05).Moreover,white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in the observation group were significantly lower than those of the control group(P<0.05).The treatment efficiency of observation group was improved,the improvement of duration of mechanical ventilation,length of intensive care unit stay and the success rate of weaning for the first time were significantly enhanced(P<0.05).Conclusions The therapy of vibration sputum drainage combined with fiberoptic bronchoscope could improve the respiratory function,reduce the duration of mechanically ventilated,enhance the rate of recovery and achieve significant therapeutic effect of severe pneumonia patients.