本文關(guān)鍵詞： 慢性阻塞性肺疾病 機(jī)械通氣 纖維支氣管鏡 咳嗽峰流速 拔管　出處：《中國(guó)內(nèi)鏡雜志》2015年10期 　論文類型：期刊論文

【摘要】：目的探討纖維支氣管鏡在低咳嗽峰流速(CPEF)慢性阻塞性肺疾病(COPD)患者拔管后的應(yīng)用價(jià)值。方法選取2010年9月-2014年9月在該院重癥監(jiān)護(hù)病房(ICU)住院治療的COPD患者68例,所有患者均行氣管插管機(jī)械通氣且CPEF值60 L/mim。將患者隨機(jī)分為觀察組和對(duì)照組各34例。對(duì)照組采用常規(guī)方法進(jìn)行排痰,觀察組每日主動(dòng)給予一次纖支鏡氣道引流,并根據(jù)患者臨床具體情況增加使用次數(shù)。比較兩組患者拔管后急性生理學(xué)與慢性健康狀況評(píng)分系統(tǒng)(APACHEⅡ)評(píng)分、肺部各項(xiàng)指標(biāo)、ICU住院時(shí)間、再插管率及拔管后并發(fā)癥發(fā)生率。結(jié)果拔管后,觀察組患者APACHEⅡ評(píng)分為(6.5±2.9)分明顯低于對(duì)照組(7.9±3.1)(P0.05);觀察組患者的呼吸頻率、血氧飽和度、血氧分壓及二氧化碳分壓均優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者再插管率為14.71%,明顯低于對(duì)照組再插管率(23.53%),差異有統(tǒng)計(jì)學(xué)意義(P0.05);撤機(jī)后觀察組患者在ICU的住院時(shí)間低于對(duì)照組,呼吸機(jī)相關(guān)性肺炎及肺不張的發(fā)生率低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論將纖支鏡引流應(yīng)用于低CPEF的COPD患者可以降低再插管率及并發(fā)癥的發(fā)生率,改善患者的缺氧狀態(tài),縮短ICU住院時(shí)間。
[Abstract]:Objective to investigate the value of fiberoptic bronchoscopy in the treatment of chronic obstructive pulmonary disease (COPD) with low cough peak flow velocity (CPEF) after extubation. Methods 68 patients with COPD were hospitalized in intensive care unit (ICU) from September 2010 to September 2014. All the patients were given mechanical ventilation with 60 L / m CPEF. The patients were randomly divided into the observation group (n = 34) and the control group (n = 34). The acute physiology and chronic health status of the two groups after extubation were compared with the Apache 鈪，

本文編號(hào)：1499139