本文選題：呼吸機(jī)相關(guān)性肺炎 + 纖維支氣管鏡�。� 參考：《中華醫(yī)院感染學(xué)雜志》2015年08期

【摘要】：目的探討纖維支氣管鏡對(duì)嚴(yán)重呼吸機(jī)相關(guān)性肺炎患者臨床癥狀及呼吸力學(xué)參數(shù)的影響,為臨床制定干預(yù)措施提供依據(jù)。方法選取醫(yī)院2011年6月-2014年10月收治的80例嚴(yán)重呼吸機(jī)相關(guān)性肺炎患者作為研究對(duì)象,隨機(jī)分為觀察組和對(duì)照組,每組各40例,兩組患者確診后均給予常規(guī)抗菌藥物治療,對(duì)照組在此基礎(chǔ)上給予常規(guī)灌洗吸痰,觀察組則給予纖維支氣管鏡肺泡灌洗吸痰治療,對(duì)治療過程中兩組患者的呼吸力學(xué)參數(shù)、肺部感染情況及臨床療效進(jìn)行比較分析。結(jié)果觀察組在治療1h和4h后氣道峰壓(PIP)、動(dòng)態(tài)順應(yīng)性(Cdyn)、氣道阻力(Raw)及呼吸功(WOB)參數(shù)均明顯優(yōu)于對(duì)照組;治療后兩組患者CPIS評(píng)分相比治療前均有不同程度改善,觀察組治療3、5、7d的評(píng)分相比對(duì)照組明顯降低;治療后觀察組痊愈29例占72.5%,顯效9例占22.5%,對(duì)照組痊愈16例占40.0%,顯效18例占45.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論纖維支氣管鏡肺泡灌洗吸痰治療嚴(yán)重呼吸機(jī)相關(guān)性肺炎可有效改善患者的臨床感染癥狀和呼吸功能,具有顯著的臨床療效。
[Abstract]:Objective to investigate the effect of fiberoptic bronchoscopy on the clinical symptoms and respiratory mechanical parameters in patients with severe ventilator-associated pneumonia and to provide evidence for clinical intervention. Methods from June 2011 to October 2014, 80 patients with severe ventilator-associated pneumonia were randomly divided into observation group and control group with 40 cases in each group. The patients in both groups were treated with routine antimicrobial agents after diagnosis. The control group was treated with routine lavage and sucking sputum, while the observation group was treated with bronchoalveolar lavage and aspiration. The respiratory mechanical parameters, pulmonary infection and clinical efficacy of the two groups were compared and analyzed. Results the parameters of peak airway pressure (PIP), dynamic compliance (C dyn), airway resistance (AR) and respiratory motility (WOB) in the observation group were significantly better than those in the control group after 1 h and 4 h of treatment, and CPIS scores of the two groups were improved in different degrees after treatment. The scores of the observation group were significantly lower than that of the control group, the scores of the observation group were significantly lower than that of the control group, and 29 cases were cured in the observation group (72.5 cases), 9 cases had remarkable effect (22.5D), 16 cases in the control group (40.05%) and 18 cases (45.0%) in the control group, the difference was statistically significant (P 0.05). Conclusion bronchoalveolar lavage and sputum aspiration in the treatment of severe ventilator-associated pneumonia can effectively improve the clinical infection symptoms and respiratory function of patients with significant clinical efficacy.
【作者單位】： 武漢市中心醫(yī)院呼吸內(nèi)科;東莞市塘廈醫(yī)院中醫(yī)科;
【基金】：廣東省衛(wèi)生廳基金資助項(xiàng)目(A20026725)
【分類號(hào)】：R563.1

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