摘要
目的 观察纤维支气管镜联合气道廓清治疗对重症肺炎机械通气患者的临床疗效。方法 选择本院重症医学科2021年4月—2022年12月收治的重症肺炎机械通气的病例80例为研究对象,根据随机双盲的原则分为对照组(n=40)与治疗组(n=40),对照组采取抗感染、机械通气等常规治疗,治疗组在对照组治疗方案的基础上增加纤维支气管镜联合气道廓清的集束化治疗,比较两组治疗前后血气分析的氧合指标、病原菌检出率、机械通气治疗时间、治疗有效率及死亡率。结果 治疗后,治疗组的动脉氧分压、氧合指数、气道峰压下降程度等改善情况优于对照组,差异有统计学意义(P<0.05)。治疗组检测出42株病原菌,对照组检测出28株病原菌,治疗组病原学确诊时间短于对照组,差异有统计学意义(P<0.05)。治疗组的机械通气治疗时间短于对照组,差异有统计学意义(P<0.05),治疗组治愈率高于对照组,死亡率低于对照组,差异有统计学意义(P<0.05)。结论 纤维支气管镜治疗能直观气道情况,有效清除气道分泌物,提高病原学检测率,从而能根据病原学结果优化抗感染方案,提高治愈率;该集束化治疗能有效改善患者通气功能,降低气道峰压、减少肺不张,缩短机械通气治疗时间。
Objective To observe the clinical effect of fiber bronchoscopy combined with airway clearance in mechanical ventilation of severe pneumonia patients.Methods 80 cases of mechanical ventilation of severe pneumonia admitted to the Department of Intensive Care Medicine of our hospital from April 2021 to December 2022 were selected as the study objects,and were divided into control group(n=40)and treatment group(n=40)according to the principle of random double blindness.The control group was given routine treatment such as anti-infection and mechanical ventilation,and the treatment group was added with fiber branches on the basis of the treatment plan of the control group.The oxygenation index,pathogen detection rate,mechanical ventilation treatment time,effective rate and mortality of blood gas analysis before and after treatment were compared between the two groups combined with airway clearance bunding therapy.Results After treatment,the improvement of arterial oxygen partial pressure,oxygenation index and airway rise under peak pressure in the treatment group was better than that in the control group,the differences were significant(P<0.05);42 strains of pathogenic bacteria were detected in the treatment group and 28 strains were detected in the control group. The diagnosis time of etiology in the treatment group was shorter than that in the control group, the difference was significant (P<0.05). The mechanical ventilation treatment time of the treatment group was shorter than that of the control group (P<0.05), the cure rate of the treatment group was higher than that of the control group, and the mortality rate was lower than that of the control group, the difference was significant (P< 0.05). Conclusion Bronchoscopy treatment can direct the airway condition, effectively remove airway secretions, improve the etiological detection rate, and thus optimize the anti-infection program according to the etiological results, and improve the cure rate;The bunching treatment can effectively improve the ventilation function of patients, reduce airway peak pressure, reduce atelectasis, and shorten the treatment time of mechanical ventilation.
作者
林福筹
姚慧文
吴嘉锟
梁锦堂
LIN Fuchou;YAO Huiwen;WU Jiakun;LIANG Jintang(Xinhui People's Hospital,Jiangmen Guangdong 529100)
出处
《智慧健康》
2024年第6期76-80,共5页
Smart Healthcare
关键词
纤维支气管镜
气道廓清治疗
重症肺炎机械通气
临床疗效
Fiber bronchoscopy
Airway clearance therapy
Mechanical ventilation for severe pneumonia
Clinical effect
