CAJ | 학술논문

目的：探讨机械通气下支气管镜吸痰及支气管肺泡灌洗（BAL）对慢性阻塞性肺疾病（COPD）合并呼吸衰竭患者的疗效。方法：60例 COPD 合并呼吸衰竭均实施有创机械通气，对照组用吸痰管常规吸痰，灌洗组在对照组治疗基础上行 BAL，观察两组在治疗前后各项指标变化。结果：灌洗组治疗后1 h SpO2、4 d 气道吸气峰压及动脉血气较对照组明显改善（P ＜0．01）；灌洗组治疗后7 d 白细胞总数（WBC）和C反应蛋白（CRP）水平较对照组明显降低（P ＜0．01）；灌洗组有创通气时间及住院时间均较对照组均明显下降（P ＜0．01），两组均无严重并发症。结论：在机械通气支持下，行气管镜 BAL 是安全有效的，并且能缩短COPD 合并呼吸衰竭患者住院时间及改善患者病情。
목적：탐토궤계통기하지기관경흡담급지기관폐포관세（BAL）대만성조새성폐질병（COPD）합병호흡쇠갈환자적료효。방법：60례 COPD 합병호흡쇠갈균실시유창궤계통기，대조조용흡담관상규흡담，관세조재대조조치료기출상행 BAL，관찰량조재치료전후각항지표변화。결과：관세조치료후1 h SpO2、4 d 기도흡기봉압급동맥혈기교대조조명현개선（P ＜0．01）；관세조치료후7 d 백세포총수（WBC）화C반응단백（CRP）수평교대조조명현강저（P ＜0．01）；관세조유창통기시간급주원시간균교대조조균명현하강（P ＜0．01），량조균무엄중병발증。결론：재궤계통기지지하，행기관경 BAL 시안전유효적，병차능축단COPD 합병호흡쇠갈환자주원시간급개선환자병정。
Objective To investigate the effects of continuous invasive mechanical ventilation combined with BAL on COPD patients with respiratory failure. Methods Sixty COPD patients with respiratory failure were divided into BAL and control group randomly. Control group were treated with sputum suction tube to aspire sputum and BAL group treated with BAL. The changes in the indicators were observed. Results The SpO2, airway peak inspiratory pressure and blood gas analysis were improved significantly compared with the control group (P < 0.01). The number of peripheral blood leucocytes and the level of CRP in BAL group were lower than those in control group at the seventh day (P < 0.01). The duration of invasive mechanical ventilation and hospital stay in BAL group was shorter than that in control group (P < 0.01) and there was no severe complication in both groups. Conclusion BALwith continuous mechanical ventilation support are safe and effective and shorten hospitalization time and improve the prognosis of COPD patients with respiratory failure.