本文選題：帕金森病　切入點：咳嗽峰流速　出處：《重慶醫(yī)學》2017年23期 　論文類型：期刊論文

【摘要】：目的探討纖維支氣管鏡引流在低咳嗽峰流速(CPEF)帕金森氏病(PD)患者拔管后的應用價值。方法采用前瞻性對照研究方法,選擇2011年11月至2015年12月收治PD合并肺部感染需要行氣管插管機械通氣的26例患者,在順利通過自主呼吸試驗(SBT)1h后囑患者用力咳嗽,測定CPEF,完成測量后拔除氣管插管,根據(jù)測定CPEF平均值將其分為高CPEF組(CPEF≥60L/min)和低CPEF組(CPEF60L/min)。高CPEF組患者根據(jù)痰液情況由護士床旁吸痰;低CPEF組每天主動給予1次纖維支氣管鏡引流。將拔管后72h內(nèi)不需重新插管視為拔管成功。比較兩組患者性別、年齡、拔管前急性生理學與慢性健康狀況評分系統(tǒng)Ⅱ(APACHEⅡ)評分、機械通氣時間、再插管率、拔管后ICU住院時間、28d病死率。結果 26例PD患者中高CPEF組17例,低CPEF組9例。兩組在年齡、性別方面比較差異無統(tǒng)計學意義(P0.05);兩組拔管前APACHEⅡ評分、兩組機械通氣時間及28d病死率、再插管率比較無統(tǒng)計學差異(P0.05);低CPEF組拔管后ICU住院時間明顯延長(P0.05)。結論低CPEF患者拔管后應用纖維支氣管鏡引流可以降低再插管率,避免通氣時間延長,但不能縮短拔管后ICU住院時間及降低病死率。
[Abstract]:Objective to evaluate the value of fiberoptic bronchoscopic drainage after extubation in patients with Parkinson's disease (PDD) with low cough peak flow velocity (CPEF). From November 2011 to December 2015, 26 patients with PD complicated with pulmonary infection who needed tracheal intubation mechanical ventilation were selected. They were told to cough forcefully and measure CPEF1 h after passing SBT successfully. Tracheal intubation was removed after the measurement was completed. According to the average value of CPEF, they were divided into high CPEF group (CPEF 鈮，

本文編號：1629706