庾胜

【摘要】目的 对纤维支气管镜辅助治疗重症呼吸机相关性肺炎的应用及效果进行探讨和研究。

方法 选取我院2016年1月～2017年5月进行了重症呼吸机相关性肺炎治疗的100例患者为主要研究对象，将其随机分为对照组和观察组，各50例。对照组患者主要运用常规性的治疗方式进行治疗，观察组患者则运用纤维支气管镜辅助治疗的方式进行治疗。在治疗之后对比两组患者的痊愈相关指标以及呼吸力学指标。

结果 对照组中患者的机械通气、肺部感染、治愈以及ICU停留时间均多于观察组。两组患者在治疗后呼吸力学指标均有所改善，但是对照组中患者的PIP、Cdyn、Raw和WOB的水平显著高于观察组。差异有统计学意义（P<0.05）。结论 对重症呼吸机相关性肺炎患者进行纤维支气管镜辅助治疗有利于患者病情的改善，值得在临床进行推广。

【关键词】纤维支气管镜；辅助；重症呼吸机相关性肺炎；应用；效果

【中图分类号】R563.1 【文献标识码】A 【文章编号】ISSN.2095-6681.2018.25..02

【Abstract】Objective To study the application and effect of bronchofiberscope in the treatment of severe ventilator-associated pneumonia.Methods From January 2016 to May 2017， 100 patients with severe ventilator-associated pneumonia were randomly divided into control group and observation group with 50 cases in each group.The patients in the control group were treated by conventional treatment and the patients in the observation group were treated by fiberoptic bronchoscopy.The relative indexes of recovery and respiratory mechanics were compared between the two groups after treatment.Results In the control group，Patients with mechanical ventilation，pulmonary infection， cure and ICU stay were longer than those in the observation group.The respiratory mechanics indexes of the two groups were improved after treatment，but the levels of PIP Cdyn Raw and WOB in the control group were significantly higher than those in the observation group （P<0.05）.Conclusion Fiberoptic bronchoscopy is helpful to improve the condition of patients with severe ventilator-associated pneumonia， and it is worth popularizing in clinic.

【Key words】Fiberoptic bronchoscopy；Auxiliary；Severe ventilator-associated pneumonia；Application； Effect

重癥呼吸机相关性肺炎主要指的是患者在进行机械通气之后48小时到拔管之后的48小时内产生的肺炎。研究表明，这一疾病是一种致死率和发病率极高的疾病，其致死率甚至高达50%[1]。由此可见，对重症呼吸机相关性肺炎患者采用必要的措施控制器肺部的感染以及呼吸系统的改善有着极其重要的作用。近几年来，由于纤维支气管镜的应用不断深入，这一治疗方式在重症呼吸机相关性肺炎患者的治疗上的作用也越来越大。同时再由于这一疾病极高的致死率，逐渐成为医学领域内非常重视的一类疾病。……