王　美

天津市海河医院重症监护室，天津　300350

纤维支气管镜肺泡灌洗吸痰术治疗ICU重症肺部感染临床效果分析

王美

天津市海河医院重症监护室，天津300350

目的 探讨纤维支气管镜肺泡灌洗吸痰术治疗ICU患者重症肺部感染的安全性及临床疗效。方法 整群选取2015年10月—2016年4月该院ICU收治的肺部感染患者96例作为研究对象。随机将其分为观察组与对照组，每组患者48例，其中对照组进行常规吸痰，观察组进行纤支镜下吸痰及支气管肺泡灌洗术，比较两组两组患者通气时间、住院时间以及肺功能、炎性因子指标。结果 观察组患者机械通气时间（7.58±5.14）d，住院时间（15.05±2.28）d；对照组患者机械通气时间（9.46±1.88）d，住院时间（18.35±2.14）d；观察组患者机械通气时间、住院时间明显短于对照组，t=2.409、2.718，P＜0.05，差异有统计学意义；观察组PaO2、PaCO2、SaO2水平较对照组改善更为显著，P＜0.05；对照组治疗后CRP（131.3±47.6）mg/mL，PCT（0.99±0.45）ng/mL；观察组治疗后CRP（11.5±1.5）mg/mL，PCT（0.15±0.10）ng/mL；两组患者治疗后CRP、PCT水平均明显低于治疗前，但观察组患者CRP、PCT指标改善效果更为显著，P＜0.05，差异有统计学意义。结论对于ICU机械通气重症肺部感染患者实施纤维支气管镜联合支气管肺泡灌洗术可有效改善患者肺部感染症状。

机械通气；纤支镜吸痰；支气管肺泡灌洗术；肺部感染；临床疗效

［Abstract］Objective Fiberoptic bronchoscopy sputum suction alveolar lavage treatment the clinical curative effect and safety of ICU patients.Methods Group selection screening October 2015 to April 2016 patients with lung infection were admitted in our hospital ICU as the research object.By using stochastic indicator will be divided into the observation group（n= 48）and control group（n=48），observation group bronchoscopy microscopic sucking sputum and bronchoalveolar lavage，comparing two groups of patients with the clinical indexes and the treatment effect and the screen of all the patients.Results The observation（7.58±5.14）d groups of patients with mechanical ventilation time，hospitalization time（15.05±2.28）days；control group with the duration of mechanical ventilation（9.46±1.88）d，hospitalization time（18.35±2.14）d；patients in the observation group the duration of mechanical ventilation，hospitalization time significantly shorter than the control group，t= 2.409、2.718，P＜0.05.Observation group，PaO2，PaCO2，SaO2levels than in the control group improved more significantly（P＜0.05）.（131.3±47.6）mg/mL in treatment group and control group after CRP，PCT（0.99±0.45）ng/mL；CRP were observed after the treatment group（11.5±1.5）mg/mL，PCT（0.15±0.10）ng/mL；after treatment，the patients in the two groups of CRP and PCT water average were significantly lower in the treatment before，but the observation group patients with CRP and PCT index improved effect is more significant，P＜0.05，with statistical significance.Conclusion Patients with ICU mechanical ventilation in severe pulmonary infection implementation of fiber bronchoscope combined bronchoalveolar lavage technique.

［Key words］Mechanical ventilation；Bronchoscopy sputum suction lens；Bronchoalveolar lavage；Lung infection；Clinical curative effect

重症肺部感染是一种由多种混合或致病力极强的细菌或耐药菌感染所致，患者多为ICU住院患者，临床预后结局极差，病死率极高［1］。纤维支气管镜是近年来临床应用诊断、治疗支气管疾病的常用手段，能够准确采集痰液标本进行培养，为临床诊断与治疗提供准确的参考信息［2-3］。……