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中国初级卫生保健:2024,38(5):97-99
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纤维支气管镜吸痰灌洗在重症肺炎 并发Ⅱ型呼吸衰竭患者中的应用
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中文摘要: 摘 要:目的:探讨不同吸痰方式即纤维支气管镜吸痰灌洗和常规吸痰管吸痰在重症肺炎并发Ⅱ型呼吸衰竭患者中的应 用效果。方法:选取2021年12月—2022年11月商丘市立医院收治的94例重症肺炎并发Ⅱ型呼吸衰竭患者,采用随机数字表 法将其分为对照组 (n=47) 和观察组 (n=47)。给予对照组患者常规吸痰管吸痰,给予观察组患者纤维支气管镜吸痰灌洗。 观察两组患者症状控制情况、血气指标及炎性反应指标。结果:干预后,观察组患者临床肺部感染评分、急性生理性与慢性 健康状况评分较对照组患者低,发热时间及机械通气时间较对照组患者短,差异均有统计学意义(t值分别为3.422、5.216、 7.668和6.945,P值均<0.05);干预后,观察组患者动脉血氧分压、动脉血氧饱和度较对照组患者高,动脉二氧化碳分压较 对照组患者低,差异均有统计学意义 (t 值分别为 2.822、6.252 和 7.705,P 值均<0.05);干预后,观察组患者降钙素原 (PCT)、C-反应蛋白(CRP)、白细胞介素(IL)-6及可溶性细胞间黏附分子-1(sICAM-1)水平较对照组患者低,差异均有 统计学意义 (t值分别为7.167、7.368、3.093和10.081,P值均<0.05)。结论:与常规吸痰管吸痰相比,纤维支气管镜吸痰 灌洗能对重症肺炎并发Ⅱ型呼吸衰竭患者血气水平进行调节,改善炎症反应,进而控制临床症状。
Abstract:Abstract: OBJECTIVE To investigate the effect of different sputum aspiration methods (bronchofiberaspiration aspiration and conventional sputum aspiration tube aspiration) in patients with severe pneumonia complicated with type II respiratory failure, and the effects on blood gas indexes and inflammatory response levels. METHODS 94 patients with severe pneumonia complicated with type II respiratory failure in our department were divided into 2 groups (random number table method) from December 2021 to De⁃ cember 2022. 47 cases in the control group were given conventional sputum aspiration tube, and 47 cases in the observation group were given bronchoscope sputum aspiration lavage. Symptom control, blood gas index and inflammatory response index were ob⁃ served. RESULTS After intervention, the clinical pulmonary infection score (CPIS), acute physiologic and chronic health status (APACHEⅡ) scores in observation group were lower than those in control group, and the fever time and mechanical ventilation time were shorter than those in control group (t=3.422,5.216,7.668,6.945,P<0.05). The partial pressure of arterial oxygen and satu⁃ ration of arterial oxygen in observation group were higher than those in control group, and the partial pressure of arterial carbon diox⁃ ide was lower than those in control group (t=2.822,6.252,7.705,P<0.05). The levels of procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6 and soluble intercellular adhesion molecule-1 (sICAM-1) in observation group were lower than those in control group(t=7.167,7.368,3.093,10.081,P<0.05). CONCLUSION Compared with conventional sputum aspiration tube, bron⁃ choscopic sputum aspiration lavage can regulate blood gas level, improve inflammatory response and control clinical symptoms in pa⁃ tients with severe pneumonia complicated with type II respiratory failure.
文章编号:3202410024     中图分类号:R563.1    文献标志码:
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