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[1]赖敏,莫诗瑶,涂彩坤.纤维支气管镜在慢性阻塞性肺部疾病急性加重期合并严重呼吸衰竭治疗中临床研究[J].慢性病学杂志,2017,(03):253-255.
　LAI Min*,MO Shi-yao,TU Cai-kun.Application value of fiberoptic bronchoscopy in the treatment of patients with acute exacerbation chronic obstructive pulmonary disease complicated with severe respiratory failure[J].,2017,(03):253-255.
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纤维支气管镜在慢性阻塞性肺部疾病急性加重期合并严重呼吸衰竭治疗中临床研究(PDF)

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
期数:
2017年03期
页码:
253-255
栏目:
论著
出版日期:
2017-04-17

文章信息/Info

Title:
Application value of fiberoptic bronchoscopy in the treatment of patients with acute exacerbation chronic obstructive pulmonary disease complicated with severe respiratory failure
作者:
赖敏1; 莫诗瑶2; 涂彩坤1
1 茂名市石化医院，广东茂名525000；2 茂名市人民医院，广东茂名525000
Author(s):
LAI Min*;  MO Shi-yao;  TU Cai-kun
*Maoming Petrochemical Hospital, Maoming, Guangdong 525000, China Corresponding author：LAI Min, E-mail: lilian1608@163.com
关键词:
纤支镜; 慢性阻塞性肺部疾病; 急性加重期; 呼吸衰竭
Keywords:
Fiberoptic bronchoscopy;  Chronic obstructive pulmonary disease;  Acute exacerbation;  Respiratory failure
分类号:
R454
DOI:
-
摘要:
目的探讨纤维支气管镜在慢性阻塞性肺部疾病（COPD） 急性加重期（AECOPD） 合并严重呼吸衰竭 治疗中的应用价值。方法选择茂名市石化医院2015年10月—2016年7月收治的84例AECOPD 合并严重呼吸 衰竭患者作为研究对象，采取随机抽签法分为对照组和观察组，每组42例。对照组在喉镜的协助下接受经口气管 插管和负压吸痰有/无创序贯机械通气治疗，观察组在纤支镜协助下经鼻气管插管及纤支镜吸痰、支气管肺泡灌 洗后有/无创序贯机械通气治疗，比较两组患者平均插管时间、第一次插管成功率及并发症率，记录两组患者第 一次插管成功率、平均插管时间、并发症率、有创通气时间、呼吸衰竭纠正时间、肺部感染控制窗（PIC） 出现 时间、痰培养阳性率。结果观察组患者第一次插管成功率95.24% （40/42）、平均插管时间（4.01 ± 2.34） min、出院前并发症率为2.38% （1/42），均优于对照组的76.19% （32/42）、（8.22 ± 4.10） min、14.29% （6/ 42），两组比较差异均有统计学意义（χ2=6.222，P=0.013；t=5.779，P=0.001；χ2=3.896，P=0.048）；对照组和 观察组插管后呼吸衰竭纠正时间分别为（9.15±1.12） 和（19.57±1.62） h，有创通气时间分别为（5.12±0.98） 和（11.27 ± 2.01） d，PIC 出现时间分别（5.11 ± 1.13） 和（10.57 ± 2.41） d，痰培养阳性率分别为80.95%和 54.76%，插管后的相关指标比较，观察组均优于对照组（P<0.05）。结论纤支镜在AECOPD 合并严重呼吸衰 竭的治疗中，可有效提高一次插管成功率，缩短插管时间，减少并发症，安全性高，有助于提高其治疗效果。
Abstract:
Objective To investigate the application value of fiberoptic bronchoscopy in the treatment of patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) complicated with severe respiratory failure. Methods A total of 84 AECOPD patients with severe respiratory failure were enrolled in Maoming Petrochemical Hospital from October 2015 to July 2016. The subjects were divided into observation group and control group according to the random sampling method, each 42. Control group received oral tracheal intubation and negative pressure suction or noninvasive sequential mechanical ventilation with the aid of laryngoscopy. The observation group underwent nasopharyngeal intubation and bronchoscopy suction, bronchial alveolar lavage with or without invasive sequential mechanical ventilation. The first success rate of intubation, average intubation time, complication rate, invasive ventilation time, respiratory failure correction time, occurrence time of pulmonary infection control window（ PIC）, sputum culture positive rate in the two groups were recorded. Results The first successrate of intubation, mean intubation time and prenatal complications was 95.24% (40/42), (4.01 ± 2.34) min, 2.38% (1/42), respectively in the observation group. The above indexes in the control group was 85.71% (36/42), (8.22±4.10) min, 11.90% (5/42), respectively. The difference between the two groups was significant (χ2=6.222, P=0.013; t=5.779, P=0.001; χ2=3.896, P=0.048). In the control group and observation group, after intubation, the corrected time of respiratory failure was (9.15±1.12)h, (19.57 ± 1.62)h, respectively; invasive ventilation time was （5.12 ± 0.98）d, （11.27 ± 2.01）d, respectively; occurrence time of PIC was （5.11±1.13）d,（10.57±2.41）d, respectively; the positive rate of sputum culture was 80.95%, 54.76%, respectively. The above idexes in the observation group were better than those in the control group (all P<0.05). Conclusion The fiberoptic bronchoscopy in the treatment of patients with AECOPD complicated with severe respiratory failure can effectively improve the first success rate of intubation, shorten the intubation time, reduce complications, and it is safe, and it helps to improve the treatment effect.

参考文献/References:

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备注/Memo

备注/Memo:
作者简介：赖敏，大学本科，主治医师，研究方向：呼吸内科 通信作者：赖敏，E-mail: lilian1608@163.com
更新日期/Last Update: 2017-03-18