CAJ | 학술논문

目的：观察纤维支气管镜吸痰联合肺泡灌洗治疗COPD合并呼吸衰竭的临床效果。方法选取本院2012年12月~2014年2月收治的100例COPD合并呼吸衰竭患者，给予有创机械通气的同时随机均分为观察组和对照组各50例，均给予镇静镇痛、营养支持、抗炎治疗，另观察组给予纤维支气管镜吸痰联合肺泡灌洗治疗，对照组给予普通吸痰管吸痰治疗，观察两组动脉血气分析、呼吸衰竭纠正时间、肺部阴影消散时间、有创机械通气时间等情况及不良反应。结果治疗后两组动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)和血氧饱和度(SaO2)均较治疗前改善，差异有统计学意义(P<0.05)；且观察组改善更明显，与对照组比较，差异有统计学意义(P<0.05)。观察组有创机械通气时间、呼吸衰竭纠正时间和肺部阴影消散时间短于对照组，差异有统计学意义(P<0.05)。两组未见严重不良反应。结论应用纤维支气管镜吸痰联合支气管肺泡灌洗治疗COPD合并呼吸衰竭，可以有效改善氧合和肺内通气，利于肺部炎症控制，且安全性较好，值得推广应用。
목적：관찰섬유지기관경흡담연합폐포관세치료COPD합병호흡쇠갈적림상효과。방법선취본원2012년12월~2014년2월수치적100례COPD합병호흡쇠갈환자，급여유창궤계통기적동시수궤균분위관찰조화대조조각50례，균급여진정진통、영양지지、항염치료，령관찰조급여섬유지기관경흡담연합폐포관세치료，대조조급여보통흡담관흡담치료，관찰량조동맥혈기분석、호흡쇠갈규정시간、폐부음영소산시간、유창궤계통기시간등정황급불량반응。결과치료후량조동맥혈양분압(PaO2)、동맥혈이양화탄분압(PaCO2)화혈양포화도(SaO2)균교치료전개선，차이유통계학의의(P<0.05)；차관찰조개선경명현，여대조조비교，차이유통계학의의(P<0.05)。관찰조유창궤계통기시간、호흡쇠갈규정시간화폐부음영소산시간단우대조조，차이유통계학의의(P<0.05)。량조미견엄중불량반응。결론응용섬유지기관경흡담연합지기관폐포관세치료COPD합병호흡쇠갈，가이유효개선양합화폐내통기，리우폐부염증공제，차안전성교호，치득추엄응용。
Objective To observe the effects of sputum suction by fiber bronchoscope and alveolar wash on patients with COPD and respiratory failure. Methods From December 2012 to February 2014,100 patients with COPD and res-piratory failure admitted into our hospital were evenly divided into observation group and control group in random.Ex-cept invasive mechanical ventilation,both groups were provided with sedation,analgesia,nutritional support,and anti-in-flammation.In addition,in observation group,sputum suction by fiber bronchoscope combining with alveolar wash was provided,while in control group,normal sputum-aspirating tube was applied.Arterial blood gas analysis,correction time of respiratory failure,disappearing time of pulmonary shadow,time of invasive mechanical ventilation and adverse reaction were observed in both groups. Results Values of PaO2,PaCO2 and SaO2 after treatment in the two groups had significant difference compared with that before treatment (P<0.05);and the two groups also had significant difference (P<0.05). Time of invasive mechanical ventilation,correction time of respiratory failure,and disappearing time of pulmonary shad-ow in the observation group was shorter than that in the control group,with significant difference (P<0.05).There was no severe adverse reactions occurred in the two groups. Conclusion Application of sputum suction by fiber bronchoscope and alveolar wash in the treatment of COPD combining with respiratory failure can effectively improve oxygenation and intrapulmonary ventilation.It is beneficial to pulmonary inflammation control and with a good safety,which is worthy of expansion.