發(fā)布時間：2018-04-17 00:21

  本文選題：支氣管肺泡灌洗 + 有創(chuàng)機械通氣　； 參考：《川北醫(yī)學院》2012年碩士論文

【摘要】：目的：觀察在使用有創(chuàng)機械通氣的慢性阻塞性肺疾�。–OPD）患者中進行常規(guī)支氣管肺泡灌洗的療效。 方法：96例COPD合并Ⅱ型呼吸衰竭患者在有創(chuàng)機械通氣的基礎上，通過常規(guī)吸痰術分為有痰組和無痰組，有痰組隨機分為兩組，一組繼續(xù)給予有創(chuàng)機械通氣，簡稱A組，另一組在有創(chuàng)機械通氣的基礎上每天予以支氣管肺泡灌洗，簡稱B組；無痰組亦隨機分為兩組，一組繼續(xù)給予有創(chuàng)機械通氣，簡稱C組，另一組在有創(chuàng)機械通氣的基礎上每天予以支氣管肺泡灌洗，簡稱D組。觀察四組患者血氣指標（pH、PaCO_2、PaO_2），有創(chuàng)機械通氣時間，RICU住院天數，RICU住院費用 結果：有痰組患者在治療后pH大致恢復到正常范圍，PaCO_2下降，，PaO_2升高，兩組比較差異有統(tǒng)計學意義（P0.05）；轉歸方面，B組的機械通氣時間、RICU住院時間以及RICU使用費用等均較A組短（P0.05）；無痰組患者在治療后pH亦恢復到正常范圍，PaCO_2下降，PaO_2升高，兩組比較差異無統(tǒng)計學意義（P＞0.05）；轉歸方面，D組的機械通氣時間、RICU住院時間以及RICU費用等亦較C組短，但兩組比較差異無統(tǒng)計學意義（P＞0.05）。 結論：在有痰組中常規(guī)支氣管肺泡灌洗在COPD合并Ⅱ型呼吸衰竭患者中應用均較單純使用有創(chuàng)機械通氣更能使PaCO_2降低明顯，PaO_2升高明顯，pH恢復明顯；且亦縮短了機械通氣時間、RICU住院時間以及節(jié)省了RICU住院費用；而在無痰組中常規(guī)支氣管肺泡灌洗在COPD合并Ⅱ型呼吸衰竭患者中應用較單純使用有創(chuàng)機械通氣PaCO_2有降低，PaO_2有升高，pH有恢復，機械通氣時間、RICU住院時間有所縮短以及RICU住院費用減少，但兩組比較差異無統(tǒng)計學意義，須待進一步研究。
[Abstract]:Objective: To observe the effect of conventional bronchoalveolar lavage in patients with chronic obstructive pulmonary disease (COPD) using invasive mechanical ventilation.
Methods: 96 cases of COPD patients with type II respiratory failure on the basis of mechanical ventilation, through conventional sputum suction were divided into phlegm group and non phlegm group phlegm group were randomly divided into two groups, one group to continue to give the invasive mechanical ventilation, referred to as A group, another group in the foundation mechanical ventilation on the day to bronchoalveolar lavage, referred to as B group; no phlegm group were randomly divided into two groups, one group to continue to give the invasive mechanical ventilation, referred to as C group, another group in the basis of mechanical ventilation on the day of bronchoalveolar lavage, referred to as D group. Four groups were observed in patients with blood gas index (pH, PaCO_2, PaO_2), mechanical ventilation time, RICU length of stay, hospitalization costs RICU
Results: the sputum group of patients after treatment of pH return to the normal range, PaCO_2 decreased, PaO_2 increased, there was significant difference between two groups (P0.05); outcome, the duration of mechanical ventilation in group B, RICU and RICU use the cost of hospitalization were shorter than those of group A (P0.05); group of patients without sputum after treatment of pH also returned to normal range, PaCO_2 decreased, PaO_2 increased, the difference between the two groups was not statistically significant (P > 0.05); prognosis, duration of mechanical ventilation in group D, RICU and RICU also cost the hospitalization time was shorter than that of group C, but the two groups but no significant difference (P > 0.05).
Conclusion: in the conventional bronchoalveolar lavage sputum group in the COPD patients with type II respiratory failure in the application are relatively simple use of invasive mechanical ventilation can cause PaCO_2 decreased significantly, PaO_2 increased significantly, pH recovery is obvious; and also shorten the mechanical ventilation time, RICU stay and save the hospitalization expenses and RICU; in the absence of routine bronchoalveolar lavage sputum group in the COPD patients with type II respiratory failure in the application of a simple use of invasive mechanical ventilation in PaCO_2 decreased, PaO_2 increased, pH recovery, mechanical ventilation time, hospitalization time was shortened RICU and RICU reduced hospitalization costs, but the difference between the two groups was not statistically significant, subject to further study.

【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R563.9

【參考文獻】

相關期刊論文 前10條

1 羅曼;陳平;羅紅;;慢性阻塞性肺疾病呼吸衰竭患者有創(chuàng)機械通氣后行支氣管肺泡灌洗并局部注藥治療(附40例報告)[J];中國醫(yī)師雜志;2006年08期

2 劉景艷,修清玉;細胞因子在慢性阻塞性肺疾病發(fā)病中的作用[J];國外醫(yī)學.呼吸系統(tǒng)分冊;2005年06期

3 費敏,王選錠;呼吸機相關性肺炎的非藥物性預防[J];國外醫(yī)學.呼吸系統(tǒng)分冊;2005年07期

4 鐘定,許輝,陽顯慧,覃壽明;支氣管肺泡灌洗和支纖鏡檢術后感染率的比較[J];廣西醫(yī)科大學學報;1997年02期

5 劉小軍;;纖維支氣管鏡肺泡灌洗對ICU機械通氣患者的臨床研究[J];河南外科學雜志;2010年05期

6 馬利軍;李玉光;;支氣管肺泡灌洗術的臨床應用[J];實用診斷與治療雜志;2007年11期

7 吳茱萸;唐思源;李耀軍;;纖維支氣管鏡吸痰聯(lián)合肺泡灌洗在慢性阻塞性肺疾病呼吸衰竭有創(chuàng)機械通氣中的應用[J];中華實用診斷與治療雜志;2009年04期

8 翟愛東;張立新;;支氣管肺泡灌洗治療難治性肺部感染體會[J];中外醫(yī)療;2008年34期

9 葉永青;王秀芬;張煒;;支氣管肺泡灌洗在嚴重肺部感染中的治療作用[J];臨床肺科雜志;2006年06期

10 吳群;楊紅衛(wèi);;機械通氣下經纖支鏡灌洗治療嚴重肺部感染[J];臨床肺科雜志;2007年12期

本文編號：1761235