| 斯琴高娃,徐静,哈斯棍,等.纤维支气管镜肺泡灌洗在机械通气下卒中相关性肺炎治疗中的应用效果研究[J].安徽医药,2021,25(1):47-50. |
| 纤维支气管镜肺泡灌洗在机械通气下卒中相关性肺炎治疗中的应用效果研究 |
| Study on the effect of fiberoptic bronchoscopic alveolar lavage in the treatment of stroke?related pneumonia under mechanical ventilation |
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| DOI：10.3969/j.issn.1009?6469.2021.01.012. |
| 中文关键词: 肺炎 卒中 肺炎，吸入性 支气管肺泡灌洗 卒中相关性肺炎 呼吸，人工 |
| 英文关键词: Pneumonia Stroke Pneumonia,aspiration Bronchoalveolar lavage Stroke?associated pneumonia Respiration,artificial |
| 基金项目:内蒙古医科大学青年创新基金项目(YKE2016QNCX050) |
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| 中文摘要: |
| 目的探究纤维支气管镜肺泡灌洗在治疗机械通气下卒中病人相关性肺炎中的应用效果。方法研究对象为包头市蒙医中医医院 2016年 2月至 2018年 2月收治的 80例卒中相关性肺炎行机械通气治疗的病人，将其采用随机数字表法分成观察组与对照组各 40例，其中观察组 40例病人采用纤维支气管镜肺泡灌洗治疗，对照组 40例病人采用常规吸痰治疗。探讨实施不同治疗对血气指标、炎症指标及治疗指标的影响。结果观察组病人治疗后在白细胞(9.63±0.91)×109/L、降钙素原(0.32±0.03)ng/mL、C反应蛋白(31.63±3.57)mg/L上显著低于对照组(11.77±1.54)×109/L、(0.61±0.06)ng/mL、(46.78±4.19)mg/L，(t＝7.566、27.341、17.407，均 P＜0.05)观察组在动脉血氧分压(83.32±8.03)mmHg、动脉血氧饱和度(93.67±3.25)%上显著高于对照组(76.52±7.16)mmHg、(87.66±3.1，9)%，结果有统计学意义(t＝3.997、14.958，P＜0.05)，在动脉血二氧化碳分压上观察组结果(41.63±4.57)mmHg明显低于对照组(58.78±5.63)mmHg，(t＝14.958，P＜0.05)，观察组的 CPIS评分在治疗后 3d(5.24±0.56)分、治疗后 7d(3.01±0.32)分上显著比对照组低(6.57±0.63)分、(6.57±0.63)分，(t＝9.979、17.633，P＜0.05)观察组在机械通气总时间(25.63±2.74)h和住院时间(14.24±1.96)h上显著比对照组短(57.61±5.84)h、住院时间(20.27±2.6，3)h，(t＝31.354、 11.627，P＜0.05)。结论将纤维支气管镜肺泡灌洗应用于机械通气下卒中相关性肺炎病人的治疗时，能显著缩短机械通气总时间、住院时间及抗生素使用时间，改善病人血气指标及炎症指标，此方法值得应用与推广。 |
| 英文摘要: |
| Objective To explore the effect of fiberoptic bronchoscopy alveolar lavage in the treatment of stroke?associated pneu?monia in patients under mechanical ventilation.Methods Eighty patients with stroke?associated pneumonia treated by mechanicalventilation in Baotou Mongolian Medicine Hospital from February 2016 to February 2018 were divided into observation group andcontrol group by random number table，with 40 patients in each group.Patients in the observation group were treated by fiberoptic bronchoscopy alveolar lavage，while patients in control group were treated by conventional sputum aspiration.The effects of different treatments on blood gas，inflammation and treatment indexes were explored.Results After treatment，the levels of white blood cells(9.63±0.91)×109/L，procalcitonin(0.32±0.03)ng/mL，and C?reactive protein(31.63±3.57)mg/L in the observation group were significantly lower than those in the control group(11.77±1.54)×109/L，(0.61±0.06)ng/mL，(46.78±4.19)mg/L，the results were statistically significant(t＝7.566，27.341，17.407，all P＜0.05)，Thearterialpartial pressure of blood oxygen(83.32±8.03)mmHgand the arterial oxygen saturation(93.67±3.25)% of the observation group were significantly higher than those of the control group(76.52±7.16)mmHg and(87.66±3.19)%.The results were statistically significant(t＝3.997，14.958，P＜0.05).The observation group’s arterial carbon dioxide partial pressure(41.63±4.57)mmHg was significantly lower than that of the control group(58.78±5.63)mmHg，and the results were statistically significant(t＝14.958，P＜0.05)，the CPIS score on day 3 and 7 after treatment was(6.57±0.63)and(6.57±0.63)points in the observation group，which were significantly lower than those of the control group(5.24±0.56)and(3.01±0.32)points(t＝9.979，17.633，P＜0.05).The total time of mechanical ventilation(25.63±2.74)h and hospital? ization time(14.24±1.96)h in the observation group were significantly shorter than those of the control group(57.61±5.84)h，hos? pitalization time(20.27±2.63)h(t＝31.354，11.627，P＜0.05).Conclusion When fiberoptic bronchoscopic alveolar lavage is ap?plied to the treatment of stroke?associated pneumonia patients under mechanical ventilation，it can significantly shorten the total time of mechanical ventilation，hospitalization time and antibiotic use time，improve the blood gas index and inflammatory index of patients，which is worthy of application and promotion. |
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