支气管肺泡灌洗治疗COPD急性加重期的护理(1)
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[摘要] 目的 探讨支气管肺泡灌洗治疗慢性阻塞性肺病(COPD)急性加重期的效果和护理。 方法 将42例患者随机分为研究组(22例)和对照组(20例)，研究组采用肺泡灌洗+常规治疗法，对照组单纯采用常规治疗。护士做好灌洗术前、术中、术后的观察和护理，一周后对比治疗效果。 结果 研究组与对照组的疗效差异具有统计学意义，研究组灌洗后无并发症发生。 结论 支气管肺泡灌洗治疗COPD急性加重期的效果肯定。灌洗术前充分的准备、术中熟练配合、严密观察及持续监护、发现问题有效地处理，是灌洗顺利完成的重要保证。
[关键词] 肺泡灌洗；COPD加重期；护理
[中图分类号] R563.3 [文献标识码] B [文章编号] 1673-9701(2012)06-0078-02
The nursing experience of bronchoalveolar lavage in treatment of patients with acute exacerbation chronic obstructive pulmonary disease
LOU Xian SHENG Meiling GAO Zanmei
Department of Respiration, Jinhua City People′s Hospital in Zhejiang Province, Jinhua 321000, China
[Abstract] Objective To explore the curative effect and the best care method for treating the patients with the acute exacerbation chronicobstructive pulmonary disease (COPD) by the bronchoalveolar lavage. Methods All of 42 cases of acute exacerbation COPD were randomly divided into study group (22 cases) and control group (20 cases). Control group were given the conventional treatment, and study group were given the conventional treatment and bronchoalveolar lavage treatment. Nurses do observation and care in pre-operation, intra-operation and post-operation, and compared the effects of the treatments after a week. Results There were statistic different effects between study group and control group. There was no complication in study group. Conclusion Bronchoalveolar lavage to treat patients with acute exacerbation chronic obstructive pulmonary disease has remarkable effectiveness. It is important to ensure successful treatment with sufficient nursing preparation before the operation, the skilled cooperation, strict nursing observation, effective dealing problem and continuous monitoring during the whole treatment.
[Key words] bronchoalveolar lavage; Acute exacerbation chronic obstructive pulmonary disease; Nursing
慢性阻塞性肺病(COPD)急性加重期患者，大部分因病程长、营养不良、长期消耗、呼吸肌疲劳从而导致咳嗽无力、痰多黏稠聚集，使得气道阻塞、感染加重[1]。常规治疗效果不佳、患者住院时间长、住院费用多，部分患者的病情因不能控制而出现恶化。支气管肺泡灌洗(BAL)是经纤支镜直视下吸除气道的分泌物，通过灌洗的方法可以进一步去除远端支气管的分泌物，从而解除气道阻塞、恢复通气[2]。同时通过纤支镜吸取下呼吸道的分泌物做痰培养+药敏，减少口腔细菌污染的机会，使临床选用抗生素更有针对性，提高常规药物治疗的效果。我院自2009年1月～2011年3月在常规治疗的基础上加支气管肺泡灌洗治疗COPD加重期 ......
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