摘要
目的探讨纤维支气管镜灌洗技术在严重胸部损伤导致急性呼吸衰竭患者的应用价值。方法采用随机对照试验研究方法。收集2013年3月~2015年3月宝鸡市中心医院收治的严重胸部损伤导致急性呼吸衰竭患者66例的临床资料,男性45例,女性21例;年龄40~60岁,平均49.2岁。随机选择31例行纤维支气管镜灌洗治疗+常规治疗(实验组),另35例行单存常规治疗(对照组),比较观察两组患者的呼吸改善情况、肺部感染、呼吸机支持时间、平均住院日、平均住院费用等情况。结果两组患者治愈率100%。试验组患者在治疗后第1天和第3天呼吸次数(R)、动脉血压分压(PaO_2)、氧合指数(PaO_2/FiO_2)、血氧饱和度(SpO_2)等指标均明显优于对照组(P<0.05);试验组患者呼吸机支持时间(13.6±3.2)h、肺部感染4例、住院时间(17.4±3.3)d、住院费用(7.3±2.2)万元,对照组分别为(19.1±2.5)h、7例、(28.2±2.5)d、(9.2±2.3)万元,试验组均低于对照组(P<0.05)。结论纤维支气管镜灌洗治疗是严重胸部损伤致急性呼吸衰竭患者的一种安全、有效的辅助治疗手段。
Objective To study the therapeutic effect of bronchofibroscope lavage in treatment of patients with acute respiratory failure caused by severe thoracic trauma. Methods A total of 66 patients [ 45 were male and 21 were female with an average of 49. 2（40-60 ） years] with severe chest trauma and acute respiratory failure treated in Baoji Center Hospital from Mar. 2013 to Mar. 2015 were randomly divided into two subgroups： the experimental group （ n = 31） and the control group （n =35）. The experimental group was treated with bronchofibroscope lavage and routine medical treatment, and the control group was treated with routine medical treatment only. Respiratory improvement,pulmonary infection, ventilator support time, hospital stay and cost were compared between the two groups. Results In the two groups of patients,the cure rate was 100%. On the first and third day after treatment, the respiratory times, PaO2 , PaO2/FiO2 , SpO2 were all better in the experimental group than in the control group （ P 〈 0.05 ）. In the experimental group, the ventilator support time, pulmonary infection, average hospitalization days and cost of bespitalization were significantly better than in the control group [ （ 13.6 ± 3.2 ） h vs. （ 19. 1± 2. 5 ） h,4 vs. 7, （ 17.4 ± 3.3 ） d vs. （ 28.2 ± 2. 5 } d, （ 73± 22） thousand yuan vs. （ 92 ± 23 ） thousand yuan, P 〈 0. 05 ]. Conclusion The bronchofibroscope lavage is a safe and effective therapy for patients with acute respiratory failure by severe thoracic trauma.
出处
《创伤外科杂志》
2017年第6期417-420,共4页
Journal of Traumatic Surgery
关键词
胸部损伤
支气管镜
肺泡灌洗
呼吸衰竭
chest trauma
bronchoscopy
bronchoalveolar lavage
respiratory failure
