本文選題：支氣管肺泡灌洗 + 有創(chuàng)機(jī)械通氣��； 參考：《川北醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的：觀察在使用有創(chuàng)機(jī)械通氣的慢性阻塞性肺疾病（COPD）患者中進(jìn)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(jī)械通氣的基礎(chǔ)上，通過常規(guī)吸痰術(shù)分為有痰組和無痰組，有痰組隨機(jī)分為兩組，一組繼續(xù)給予有創(chuàng)機(jī)械通氣，簡稱A組，另一組在有創(chuàng)機(jī)械通氣的基礎(chǔ)上每天予以支氣管肺泡灌洗，簡稱B組；無痰組亦隨機(jī)分為兩組，一組繼續(xù)給予有創(chuàng)機(jī)械通氣，簡稱C組，另一組在有創(chuàng)機(jī)械通氣的基礎(chǔ)上每天予以支氣管肺泡灌洗，簡稱D組。觀察四組患者血?dú)庵笜?biāo)（pH、PaCO_2、PaO_2），有創(chuàng)機(jī)械通氣時(shí)間，RICU住院天數(shù)，RICU住院費(fèi)用 結(jié)果：有痰組患者在治療后pH大致恢復(fù)到正常范圍，PaCO_2下降，，PaO_2升高，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P0.05）；轉(zhuǎn)歸方面，B組的機(jī)械通氣時(shí)間、RICU住院時(shí)間以及RICU使用費(fèi)用等均較A組短（P0.05）；無痰組患者在治療后pH亦恢復(fù)到正常范圍，PaCO_2下降，PaO_2升高，兩組比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）；轉(zhuǎn)歸方面，D組的機(jī)械通氣時(shí)間、RICU住院時(shí)間以及RICU費(fèi)用等亦較C組短，但兩組比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。 結(jié)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(yīng)用均較單純使用有創(chuàng)機(jī)械通氣更能使PaCO_2降低明顯，PaO_2升高明顯，pH恢復(fù)明顯；且亦縮短了機(jī)械通氣時(shí)間、RICU住院時(shí)間以及節(jié)省了RICU住院費(fèi)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(yīng)用較單純使用有創(chuàng)機(jī)械通氣PaCO_2有降低，PaO_2有升高，pH有恢復(fù)，機(jī)械通氣時(shí)間、RICU住院時(shí)間有所縮短以及RICU住院費(fèi)用減少，但兩組比較差異無統(tǒng)計(jì)學(xué)意義，須待進(jìn)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(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R563.9

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