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目的:探讨床旁纤维支气管镜支气管肺泡灌洗(BAL)在急诊重症监护室(EICU)机械通气慢性阻塞性肺疾病(COPD)患者救治中的应用效果。方法:选取2015-09-2016-07我院EICU收治的86例实施有创机械通气治疗的COPD患者采用随机数字表法分为试验组和对照组各43例,2组均行常规吸痰、抗感染等治疗,试验组同时给予床旁纤维支气管镜BAL治疗,对比2组治疗效果。结果:治疗前,试验组和对照组的PaO_2、PaCO_2、pH值、SaO2、CRP、WBC水平差异无统计学意义。治疗96h后,试验组的PaO_2、pH值、SaO2水平高于对照组,差异有统计学意义(P<0.05);PaCO_2、CRP、WBC水平均低于对照组,差异有统计学意义(P<0.05)。试验组的机械通气治疗时间、ICU治疗时间均显著的低于对照组,差异有统计学意义(P<0.05);试验组的院内死亡率(2.33%)与对照组的院内死亡率(6.98%)比较差异无统计学意义。结论:床旁纤维支气管镜BAL在ICU机械通气COPD患者治疗中有利于进一步改善患者的血气指标、减轻炎症反应、缩短治疗时间。
Objective: To investigate the effect of bedside bronchofibroscope bronchoalveolar lavage (BAL) in the treatment of patients with mechanical ventilation chronic obstructive pulmonary disease (EECU) in the emergency intensive care unit (EICU). Methods: Totally 86 COPD patients who underwent invasive mechanical ventilation were enrolled in our hospital from September 2015 to September 2016. The patients were divided into experimental group and control group (n = 43) by random number table method. Both groups were performed conventional suctioning, Anti-infection and other treatment, the experimental group at the same time give the bedside bronchoscopy BAL treatment, the treatment of two groups compared. Results: There was no significant difference in PaO2, PaCO2, pH, SaO2, CRP and WBC levels between the two groups before treatment. After treatment for 96h, PaO2, pH value and SaO2 level in the experimental group were significantly higher than those in the control group (P <0.05), while PaCO2, CRP and WBC levels in the experimental group were lower than those in the control group (P < 0.05). The experimental group’s mechanical ventilation time and ICU treatment time were significantly lower than the control group, the difference was statistically significant (P <0.05); hospital mortality (2.33%) and control group hospital mortality (6.98% There was no significant difference between the two groups. Conclusion: The bedside fiberoptic bronchoscope BAL in ICU patients with mechanical ventilation COPD treatment is conducive to further improve the patient’s blood gas index, reduce the inflammatory response and shorten the treatment time.