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目的:观察纤维支气管镜吸痰联合肺泡灌洗对有创机械通气的慢性阻塞性肺疾病呼吸衰竭的治疗效果。方法:气管插管机械通气的慢性阻塞性肺疾病呼吸衰竭患者41例,随机分为纤维支气管镜吸痰联合肺泡灌洗治疗组(A组)和普通吸痰管吸痰组(B组),比较2组呼吸衰竭纠正时间、出现肺部感染控制窗的时间、有创机械通气时间、机械通气后住院天数、病死率情况。结果:2组病死率比较差异无统计学意义(P>0.05),A组呼吸衰竭纠正时间、出现肺部感染控制窗的时间、有创机械通气时间、机械通气后住院天数等指标均优于B组,差异有统计学意义(P<0.05)。结论:纤维支气管镜吸痰联合肺泡灌洗是治疗有创机械通气的慢性阻塞性肺疾病呼吸衰竭患者的有效手段,能迅速控制感染、缩短有创机械通气时间、减少撤机困难等并发症的发生,还可缩短住院时间,改善预后。
OBJECTIVE: To observe the therapeutic effect of bronchofibroscopy and bronchoalveolar lavage on respiratory failure in patients with invasive mechanical ventilation for chronic obstructive pulmonary disease. Methods: Thirty-one patients with chronic obstructive pulmonary disease (COPD) respiratory failure underwent endotracheal intubation were randomly divided into bronchoscopy combined with bronchoalveolar lavage (group A) and common suction sputum aspiration group (group B) Time to correct respiratory failure, time of pulmonary infection control window, time of invasive mechanical ventilation, days of hospitalization after mechanical ventilation, mortality were compared between the two groups. Results: There was no significant difference in mortality between the two groups (P> 0.05). The correct time of respiratory failure, the time of pulmonary infection control window, the duration of invasive mechanical ventilation and hospital stay after mechanical ventilation were all better than those of group A B group, the difference was statistically significant (P <0.05). CONCLUSIONS: Fiberoptic bronchoscopy combined with alveolar lavage is an effective treatment for patients with respiratory failure due to mechanical ventilation and chronic obstructive pulmonary disease. It can rapidly control infection, shorten the duration of invasive mechanical ventilation and reduce the complications such as weaning difficulties Occur, but also shorten the hospital stay, improve prognosis.