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目的探讨支气管肺泡灌洗实施时间对于溺水儿童治疗效果的影响。方法选择2011年8月—2014年12月收治的36例溺水儿童作为研究对象,随机分为早期组19例和晚期组17例。早期组在溺水后24 h内开始支气管肺泡灌洗;晚期组在溺水后48~72 h内开始支气管肺泡灌洗,两组均治疗一周。观察并比较两组呼吸、心率、血压、血氧饱和度、氧合指数及肺部X线阴影的好转情况等。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,早期组呼吸、心率、血压、血氧饱和度、氧合指数、肺部X线阴影好转率分别为(36.4±2.6)、(131.6±3.2)次/min、(110.4±2.3)mm Hg(1 mm Hg=0.133 k Pa)、(78.3±1.5)%、(297.0±1.9)mm Hg、89.5%,与对照组的(42.5±4.9)、(146.8±5.4)次/min、(130.5±5.1)mm Hg、(67.2±3.7)%、(264.0±3.6)mm Hg、47.1%比较差异均有统计学意义(均P<0.05)。结论早期对溺水儿童进行支气管肺泡灌洗治疗,及时地清除肺内吸入物,减轻有毒物质对肺的损害,改善通气和换气功能,从而能较快地纠正患者的生理和临床指标,疗效显著。
Objective To investigate the effect of bronchoalveolar lavage (ADLP) on the therapeutic effect of children drowning. Methods Thirty-six children with drowning admitted from August 2011 to December 2014 were selected as study subjects and randomly divided into early group (n = 19) and late group (n = 17). In the early group, bronchoalveolar lavage was started within 24 hours after the drowning. In the late group, bronchoalveolar lavage was started within 48-72 hours after the drowning, and both groups were treated for one week. Observed and compared respiration, heart rate, blood pressure, oxygen saturation, oxygenation index and the improvement of lung X-ray situation. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the improvement rates of respiration, heart rate, blood pressure, oxygen saturation, oxygenation index and pulmonary X-ray shading in the early group were (36.4 ± 2.6), (131.6 ± 3.2) mm Hg (1 mm Hg = 0.133 kPa), (78.3 ± 1.5)%, (297.0 ± 1.9) mm Hg, 89.5%, and 42.5 ± 4.9 and 146.8 ± 5.4 times / 130.5 ± 5.1 mm Hg, 67.2 ± 3.7%, 264.0 ± 3.6 mm Hg, 47.1%, respectively (all P <0.05). Conclusion Early drowning children with bronchoalveolar lavage treatment, timely removal of inhaled lung, reduce the toxic substances on lung damage, improve ventilation and ventilation function, which can quickly correct the patient’s physiological and clinical indicators, the effect was significant .