纤维支气管镜在COPD呼吸衰竭患者治疗中的 应用及其临床意义分析(1)
[摘要] 目的 探讨COPD呼吸衰竭患者治疗中纤维支气管镜的应用及其临床意义。 方法 选取2017年11月～2019年1月我院收治的COPD呼吸衰竭患者86例，随机数字表法分为两组，对照组应用常规治疗，研究组联合应用纤维支气管镜。观察比较两组治疗前后相关动脉血气指标水平变化、两组的相关通气情况及恢复情况。 结果 治疗前，两组的相关动脉血气指标无显著差异(P>0.05)，治疗后，研究组相关动脉血气指标改善情况优于对照组(P<0.05)。研究组机械通气时间显著短于对照组(P<0.05)，研究组首次撤机成功率显著高于对照组(P<0.05)，研究组呼吸机相关肺炎(VAP)的发生率显著低于对照组(P<0.05)。 结论 在对COPD呼吸衰竭患者進行治疗的过程中，应用纤维支气管镜能够显著缩短患者的住院治疗时长，降低患者发生VAP的风险，改善患者的相关动脉血气指标。
[关键词] COPD;呼吸衰竭;血气指标;呼吸机肺炎;纤维支气管镜
[中图分类号] R563.9;R563.8 [文献标识码] B [文章编号] 1673-9701(2019)33-0089-03
[Abstract] Objective To investigate the application and clinical significance of fiberoptic bronchoscopy in the treatment of patients with COPD respiratory failure. Methods 86 patients with COPD respiratory failure admitted to our hospital from November 2017 to January 2019 were enrolled. The patients were randomly divided into two groups. The control group received conventional therapy and the study group was treated with the combined use of fiberoptic bronchoscopy. The changes of the relevant arterial blood gas index levels before and after treatment in the two groups were observed and compared. The related ventilation and recovery were compared between the two groups. Results Before treatment， there was no significant difference in the relevant arterial blood gas index between the two groups(P>0.05). After treatment， the improvement of arterial blood gas index in the study group was better than that in the control group(P<0.05). The mechanical ventilation time of the study group was significantly shorter than that of the control group(P<0.05). The rate of successful first weaning in the study group was significantly higher than that of the control group(P<0.05). The incidence of ventilator-associated pneumonia(VAP) in the study group was significantly lower than that of the control group(P<0.05). Conclusion In the treatment of patients with COPD respiratory failure， the use of fiberoptic bronchoscopy can significantly shorten the length of hospitalization， reduce the risk of VAP， and improve the relevant arterial blood gas index.
[Key words] COPD; Respiratory failure; Blood gas index; Ventilator pneumonia; Fiberoptic bronchoscopy
慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)是临床呼吸内科中最为常见的一种疾病[1]。COPD患者的主要临床表现为明显的呼气气流受阻，临床特征则主要表现为不可逆的进行性发展。COPD患者的病程较长，很难进行完全治愈，给患者的生活质量及家庭造成很大的身心负担。COPD患者最常见的一种并发症就是呼吸衰竭，同时这也是导致COPD患者发生死亡的一项主要因素[2]。加重COPD患者病情及感染的因素主要为呼吸道中的分泌物显著增加，且未能进行及时有效的清理，因此，彻底对呼吸道进行清理是治疗COPD呼吸衰竭主要及重要途径[3]。本次研究选取2017年11月～2019年1月我院收治的COPD呼吸衰竭患者43例，在常规治疗的基础上联合应用纤维支气管镜，现报道如下。, http://www.100md.com(马展成)
[关键词] COPD;呼吸衰竭;血气指标;呼吸机肺炎;纤维支气管镜
[中图分类号] R563.9;R563.8 [文献标识码] B [文章编号] 1673-9701(2019)33-0089-03
[Abstract] Objective To investigate the application and clinical significance of fiberoptic bronchoscopy in the treatment of patients with COPD respiratory failure. Methods 86 patients with COPD respiratory failure admitted to our hospital from November 2017 to January 2019 were enrolled. The patients were randomly divided into two groups. The control group received conventional therapy and the study group was treated with the combined use of fiberoptic bronchoscopy. The changes of the relevant arterial blood gas index levels before and after treatment in the two groups were observed and compared. The related ventilation and recovery were compared between the two groups. Results Before treatment， there was no significant difference in the relevant arterial blood gas index between the two groups(P>0.05). After treatment， the improvement of arterial blood gas index in the study group was better than that in the control group(P<0.05). The mechanical ventilation time of the study group was significantly shorter than that of the control group(P<0.05). The rate of successful first weaning in the study group was significantly higher than that of the control group(P<0.05). The incidence of ventilator-associated pneumonia(VAP) in the study group was significantly lower than that of the control group(P<0.05). Conclusion In the treatment of patients with COPD respiratory failure， the use of fiberoptic bronchoscopy can significantly shorten the length of hospitalization， reduce the risk of VAP， and improve the relevant arterial blood gas index.
[Key words] COPD; Respiratory failure; Blood gas index; Ventilator pneumonia; Fiberoptic bronchoscopy
慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)是临床呼吸内科中最为常见的一种疾病[1]。COPD患者的主要临床表现为明显的呼气气流受阻，临床特征则主要表现为不可逆的进行性发展。COPD患者的病程较长，很难进行完全治愈，给患者的生活质量及家庭造成很大的身心负担。COPD患者最常见的一种并发症就是呼吸衰竭，同时这也是导致COPD患者发生死亡的一项主要因素[2]。加重COPD患者病情及感染的因素主要为呼吸道中的分泌物显著增加，且未能进行及时有效的清理，因此，彻底对呼吸道进行清理是治疗COPD呼吸衰竭主要及重要途径[3]。本次研究选取2017年11月～2019年1月我院收治的COPD呼吸衰竭患者43例，在常规治疗的基础上联合应用纤维支气管镜，现报道如下。, http://www.100md.com(马展成)