CAJ | 학술논문

目的：探讨经纤维支气管镜灌洗吸痰法对胸部肿瘤术后排痰困难患者吸痰效果的影响。方法将60例胸部肿瘤术后排痰困难患者，按照入住ICU顺序编号，分为对照组和观察组，每组各30例。对照组采取常规吸痰方法，观察组在此基础上采用纤维支气管镜灌洗吸痰，比较两组吸痰效果。结果观察组患者发生黏膜损伤7例，肺不张2例，肺部感染5例，均低于对照组的15，9，12例，差异有统计学意义（χ2值分别为4.59，4.01，4.02；P＜0.05）；观察组留住ICU时间为（6.25±2.58） d，对照组为（8.29±3.52）d，两组比较差异有统计学意义（t＝2.56，P＜0.05）；观察组每日平均吸痰（5．0±2.0）次，低于对照组的（7.5±2.8）次，两组比较差异有统计学意义（t＝3.98，P＜0.01）。结论采用纤维支气管镜灌洗吸痰与临床常规吸痰相结合的方法，可有效维持肺部的正常通气功能，减少低氧血症持续时间，降低胸部肿瘤术后并发症，缩短患者留住ICU的时间。
목적：탐토경섬유지기관경관세흡담법대흉부종류술후배담곤난환자흡담효과적영향。방법장60례흉부종류술후배담곤난환자，안조입주ICU순서편호，분위대조조화관찰조，매조각30례。대조조채취상규흡담방법，관찰조재차기출상채용섬유지기관경관세흡담，비교량조흡담효과。결과관찰조환자발생점막손상7례，폐불장2례，폐부감염5례，균저우대조조적15，9，12례，차이유통계학의의（χ2치분별위4.59，4.01，4.02；P＜0.05）；관찰조류주ICU시간위（6.25±2.58） d，대조조위（8.29±3.52）d，량조비교차이유통계학의의（t＝2.56，P＜0.05）；관찰조매일평균흡담（5．0±2.0）차，저우대조조적（7.5±2.8）차，량조비교차이유통계학의의（t＝3.98，P＜0.01）。결론채용섬유지기관경관세흡담여림상상규흡담상결합적방법，가유효유지폐부적정상통기공능，감소저양혈증지속시간，강저흉부종류술후병발증，축단환자류주ICU적시간。
Objective To explore the effect of fiberoptic bronchoscopy lavage sputum suction on sputum aspiration in thoracic neoplasm patients with difficulty in postoperative expectoration .Methods Sixty thoracic neoplasm patients with postoperative expectoration difficulty who met the inclusion criteria were divided into the control group and the observation group according to the order number in ICU , each with 30 cases.The control group received the conventional sputum suction , and the observation group received the fiberoptic bronchoscopy lavage sputum suction on the basis of routine sputum suction .The effect of sputum aspiration was compared between the two groups .Results The cases of complications including mucosa damage , atelectasis, pulmonary infection were respectively 7, 2 and 5 cases in the observation group , and were lower than those in the control group , and the differences were statistically significant (χ2 =4.59 ,4.01 ,4.02 , respectively;P<0.05).The time of staying in the ICU was (6.25 ±2.58) d in the observation group, and was (8.29 ±3.52) d in the control group , and the difference was statistically significant ( t=2.56 ,P<0.05 ) .The average times of sputum aspiration every day were (5.0 ±2.0) in the observation group, and were lower than (7.5 ±2.8) in the control group , and the difference was statistically significant ( t =3.98 , P <0.01 ) .Conclusions The methods of fiberoptic bronchoscopy lavage sputum suction combined with routine clinical sputum suction can effectively maintain the normal lung ventilation function , and reduce the duration of hypoxemia and the occurrence of postoperative complications , and shorten the time of staying in the ICU .