床旁纤维支气管镜治疗呼吸机相关性肺炎疗效剖析.docVIP

床旁纤维支气管镜治疗呼吸机相关性肺炎疗效剖析 　　[摘要] 目的 探究采用床旁纤维支气管镜治疗呼吸机相关性肺炎的临床疗效。方法 将该院2012年2月―2015年2月收治的66例呼吸机相关性肺炎患者，分为两组，各33例。对照组采取常规吸痰管吸痰，观察组在常规吸痰管吸痰的基础上加以床旁纤维支气管镜吸痰。对比两组临床疗效、肺部感染评分以及临床指标情况。结果 观察组在治疗后治愈率为90.9%（30/33），高于对照组治愈率的66.7%（22/33），差异有统计学意义（P0.05）。观察组在治疗后的3 d、5 d以及7 d的肺部感染评分均显著低于对照组，差异有统计学意义（P0.01）。观察组治愈时间、住ICU时间以及机械通气时间均显著短于对照组，差异有统计学意义（P0.01）。结论 对呼吸机相关性肺炎患者给予床旁纤维支气管镜治疗可显著提高临床疗效，改善临床指标，值得临床推广。 　　[关键词] 床旁纤维支气管镜；呼吸机相关性肺炎；临床疗效 　　[中图分类号] R563.1 [文献标识码] A [文章编号] 1674-0742（2015）09（b）-0060-02 　　[Abstract] Objective To explore the clinical curative effect of bedside fiberoptic bronchoscopy for ventilator-associated pneumonia. Methods 66 patients with ventilator-associated pneumonia admitted to our hospital between February 2012 and February 2015 were divided into two groups with 33 in each one. The control group used conventional sputum-aspirating tubes for sputum aspiration， while the observation group was treated with bedside fiberoptic bronchoscopy based on the method adopted in the control group. We compared the clinical efficacy， pulmonary infection score and other clinical parameters. Results The cure rate [90.9% （30/33） vs 66.7%（22/33），P0.05 ] was higher in the observation group than in the control group with statistical difference. The pulmonary infection score 3 d， 5 d， 7 d after treatment were all significantly lower in the observation group than in the control group with statistical differences， P0.01. The healing time， ICU stay time， duration of mechanical ventilation were all significantly less in the observation group than in the control group with statistical differences， P0.01. Conclusion Bedside fiberoptic bronchoscopy is worthy of promotion in the treatment of ventilator-associated pneumonia because it can improve the clinical efficacy and clinical parameters. 　　[Key words] Bedside fiberoptic bronchoscopy； Ventilator-associated pneumonia； Clinical curative effect 　　呼吸机相关性肺炎是患者采用机械通气的严重并发症，同时其也是获得新肺炎的重要类型[1]。呼吸机相关性肺炎患者病情危险，容易造成脱机困难，如果病情不断加重，不仅会延长病情，而且会对生命造成威