摘要
目的：探讨支气管镜肺灌洗联合正压通气治疗创伤性肺不张的临床疗效。方法收集2014年1月至2015年12月本科室收治的创伤性肺不张患者68例，按随机数字表分为观察组（n=34）和对照组（n=34）。对照组患者按常规方案进行治疗，观察组患者在对照组治疗方案基础上给予支气管镜肺灌洗治疗。记录治疗前后两组患者的血气分析结果和生命体征变化。比较两组患者的临床疗效，记录支气管镜肺灌洗相关并发症的发生情况。比较两组患者的呼吸困难评分、气管插管率、无创通气时间、有创通气时间、住ICU时间、总住院时间、住院费用、死亡率等情况。结果治疗后3 d进行临床疗效评价显示，观察组显效19例（55.9%），总有效率97.1%（33/34）；对照组显效7例（20.6%），总有效率为76.5%（26/34）。观察组的显效率和总有效率均显著高于对照组（均P〈0.05）。治疗前两组患者氧分压（PO2）、二氧化碳分压（PCO2）、动脉血氧饱和度（SaO2）组间比较，差异均无统计学意义（均P〉0.05）。治疗后1 h、24 h，观察组患者PO2、SaO2较对照组均显著升高（均P〈0.05）；治疗后3 d观察组患者PO2高于对照组（P〈0.05），但SaO2差异无统计学意义（P〉0.05）。治疗前后两组患者的生命体征差异均无统计学意义（均P〉0.05）。观察组患者未发生严重的治疗相关并发症。观察组患者治疗后3 d呼吸困难评分、气管插管率、无创通气时间、有创通气时间、住ICU时间、总住院时间、住院费用、死亡率等情况均显著优于对照组（均P〈0.05）。结论支气管镜肺灌洗对创伤性肺不张具有较好的临床疗效。
Objective To investigate the clinical efficacy of bronchoalveolar lavage and positive pressure ventilation in treatment of traumatic atelectasis. Methods Sixty-eight patients with traumatic atelectasis,who were hospitalized in our department between January 2014 and December 2015,were included in the study,and randomly divided into the study group（n=34）and the control group（n=34）. The control group received conventional treatment. The study group was given bronchoalveolar lavage on the basis of conventional treatment. The findings of blood gas analysis and the changes of vital signs were recorded before and after treatment. The clinical efficacy in the two groups was compared. The complications related to the bronchoalveolar lavage were recorded. The dyspnea score, tracheal intubation rate, noninvasive ventilation time,invasive ventilation time,ICU stay time,total length of hospital stay,medical costs,and mortality were compared between the two groups. Results At 3 d after treatment,the evaluation for the clinical efficacy showed that 19 cases were significantly effective（55.9%）,and the total effective rate was 97.1%（33/34）in the study group;7 were significantly effective（20.6%）,and the total effective rate was 76.5%（26/34）in the control group. The significantly effective rate and total effective rate in the study group were significantly higher than those in the control group （both P〈0.05）. There were no statistically＆amp;nbsp;significant differences in the levels of oxygen partial pressure （PO2）,partial pressure of carbon dioxide （PCO2）,and arterial oxygen saturation（SaO2）between two groups before treatment（all P〉0.05）. At 1 h and 24 h after treatment,the levels of PO2 and SaO2 in the study group were significantly increased as compared with the control group（all P〈0.05）. At 3 d after treatment,the PO2 level in the study group was higher than that in the control group（P〈0.05）,whereas there was no statistically significant difference in SaO2 level bet
作者
洪智峰
李明霞
陈杰勇
刘凤霞
Hong Zhifeng Li Mingxia Chen Jieyong Liu Fengxia(Department of Critical Care Medicine, Lecong Hospital of Shunde District, Foshan Guangdong 528315, China)
出处
《中华生物医学工程杂志》
CAS
2016年第4期323-327,共5页
Chinese Journal of Biomedical Engineering
关键词
气管镜
灌洗法
肺不张
肺损伤
急性
Bronchoscopes
Lavage
Atelectasis
Lung injury,acute
