| 刘路,梅清,潘爱军.电子支气管镜肺泡灌洗术在重症监护室机械通气伴有肺不张病人中的应用[J].安徽医药,2019,23(12):2386-2389. |
| 电子支气管镜肺泡灌洗术在重症监护室机械通气伴有肺不张病人中的应用 |
| The application of electronic bronchoscope alveolar lavage in patients with mechanical ventilation and atelectasis in intensive care unit |
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| DOI：10.3969/j.issn.1009?6469.2019.12.013 |
| 中文关键词: 肺不张 支气管肺泡灌洗 呼吸，人工 支气管镜检查 血气分析 重症监护病房 |
| 英文关键词: Pulmonary atelectasis Bronchoalveolar lavage Respiration,artificial Bronchoscopy Blood gas analysis Intensive care unit |
| 基金项目:国家临床重点专科建设项目(财社［ 2011］1563)；安徽省自然科学基金(1808085MH300) |
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| 中文摘要: |
| 目的探讨电子支气管镜肺泡灌洗术在重症监护室(ICU)机械通气伴有肺不张病人中的应用效果。方法收集 2016年 6月至 2018年 6月安徽省立医院 ICU 100例机械通气同时伴有肺不张病人的临床样本，按照随机数字表法分成观察组和对照组各 50例。对照组常规抗生素治疗，定时翻身、拍背、吸痰等常规护理。观察组在对照组基础上，定期给予电子支气管镜肺泡灌洗治疗。对比两组病人治疗 1周后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)等多项动脉血气指标的变化，肺复张情况及临床治疗效果。结果 1周前观察组和对照组病人的 PaO2分别为(72.5±14.1)mmHg和(70.3± 15.0)mmHg，SaO2分别为(88.6±4.8)%和(88.8±3.6)%，治疗 1周后，观察组与对照组病人的 PaO2分别为(81.7±11.7)mmHg和(76.1±13.1)mmHg，SaO2分别为(95.6±4.0)%和(91.4±2.6)%，观察组与对照组病人的 PaO2、SaO2均较前改善，但观察组改善更为显著，均差异有统计学意义(P＜0.05)。观察组肺复张总有效率 88%，显著高于对照组的 64%，差异有统计学意义(P＜ 0.01)。与对照组相比，观察组病人使用抗生素时间减少，机械通气时间及住 ICU天数缩短，均差异有统计学意义(P＜0.01)。结论 ICU机械通气伴有肺不张病人定期给予电子支气管镜肺泡灌洗治疗，可提高临床疗效，促进病人康复。 |
| 英文摘要: |
| Objective To investigate the effect of electronic bronchoscope alveolar lavage in ICU patients with mechanical ventila? tion and atelectasis.Methods Clinical samples of 100 patients with mechanical ventilation and atelectasis in ICU of Anhui Provin?cial Hospital from June 2016 to June 2018 were collected and divided into observation group and control group according to therandom number table method，50 patients each group.The control group received routine antibiotic treatment，routine nursing such as turning over，backslapping and sputum aspiration.On the basis of the control group，the observation group was regularly treatedwith electronic bronchoscope alveolar lavage.The changes of arterial blood gas indexes，such as arterial partial oxygen pressure(PaO2)arterial partial carbon dioxide pressure(PaCO2)and arterial oxygen saturation(SaO2)，as well as pulmonary reexpansion andclinic，al treatment effect were compared between the two groups after 1 week of treatment.Results The PaO2 in the observa? tion group and the control group 1 week ago were(72.5±14.1)mmHg and(70.3±15.0)mmHg，respectively，and the SaO2 were(88.6±4.8)% and(88.8±3.6)%，respectively.After 1 week of treatment，the PaO2 in the observation group and the control group were(81.7±11.7)mmHg and(76.1±13.1)mmHg，respectively，and the SaO2 were(95.6±4.0)% and(91.4±2.6)%，respective? ly.The PaO2 and SaO2 of the patients in the observation group and the control group were improved compared with the former，but the improvement was more significant in the observation group，and the differences were statistically significant(P＜0.05).The to? tal effective rate of pulmonary reexpansion in the observation group was 88%，which was significantly higher than 64% in the con? trol group，and the difference was statistically significant(P＜0.01).Compared with the control group，the duration of antibiotic use， mechanical ventilation time and length of ICU stay in the observation group were reduced，with statistically significant differences(P＜0.01).Conclusion Patients with mechanical ventilation accompanied by atelectasis in ICU are regularly treated with electron?ic bronchoscope alveolar lavage，which can improve the clinical efficacy and promote the recovery of patients. |
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