纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效及感染情况影响

    Effect of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration on the curative effect and infection in patients with severe pneumonia complicated with type Ⅱ respiratory failure

    • 摘要:
      目的研究纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效及感染情况影响。
      方法选取重症肺炎并发Ⅱ型呼吸衰竭病人146例,按照入院编号随机分为联合治疗组与常规治疗组,各73例。常规治疗组病人接受常规抗感染及纠正呼吸衰竭治疗,联合治疗组病人在常规治疗组基础上接受纤维支气管镜吸痰灌洗联合振动排痰治疗。比较2组病人治疗总有效率、发热时间、机械通气时间、住院时间、抗生素使用情况及治疗前后的肺部感染情况。
      结果联合治疗组治疗总有效率为93.15%,明显高于常规治疗组的78.08%(P < 0.01)。联合治疗组病人发热时间、机械通气时间和住院时间均明显低于常规治疗组(P < 0.01)。联合治疗组三联抗生素使用比例为8.22%,明显低于常规治疗组的45.21%(P < 0.01)。治疗前2组病人临床肺部感染评分(CPIS)差异无统计学意义(P>0.05));治疗5 d、14 d时,联合治疗组CPIS评分明显低于常规治疗组(P < 0.01)。
      结论纤维支气管镜吸痰灌洗联合振动排痰对重症肺炎并发Ⅱ型呼吸衰竭病人的疗效显著,明显缩短病程,有效控制感染,减少抗生素,值得在临床推广。

       

      Abstract:
      ObjectiveTo study the effects of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration on the curative effect and infection of patients with severe pneumonia complicated with type Ⅱ respiratory failure.
      MethodsA total of 146 patients with severe pneumonia complicated with type Ⅱ respiratory failure were randomly divided into the combination treatment group and conventional treatment group (73 cases each group).The conventional treatment group were treated with conventional anti-infectin and corrected respiratory failure, and the combined treatment group were treated with fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration based on the conventional treatment group.The total effective rate, time of fever, time of mechanical ventilation, time of hospitalization, use of antibiotics and pulmonary infection between two groups before and after treatment were compared.
      ResultsThe total effective rate in combined treatment group (93.15%) was significantly higher than that in conventional treatment group (78.08%) (P < 0.01).The fever time, mechanical ventilation time and hospitalization time in combined treatment group were significantly lower than that in conventional treatment group (P < 0.01).The use ratio of triple antibiotics in combined treatment group (8.22%) was significantly lower than that in conventional treatment group (45.21%) (P < 0.01).The difference of the CPIS score between two groups before treatment was not statistically significant (P>0.05), which in combined treatment group after 5d and 14d of treatment were significantly lower than that in conventional treatment group (P < 0.01).
      ConclusionsThe effect of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration in treating severe pneumonia complicated with type Ⅱ respiratory failure is good, which can significantly shorten the course of disease, effectively control infection, and reduce the use of antibiotics.It is worthy of clinical promotion.

       

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