| 摘要: |
| ［摘要］ 目的 探讨采用纤维支气管镜治疗肺癌根治术后呼吸机相关性肺炎（ventilator-associated pneumonia,VAP）患者的治疗效果，为临床治疗提供参考依据。方法 选取2013-12～2015-12该院接受肺癌根治术后并发VAP患者60例，按照不同的治疗方式分为治疗组和对照组，每组30例。治疗组实施纤维支气管镜吸痰处理，对照组实施常规吸痰处理，比较两组患者治疗前后的pH、动脉氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、血氧饱和度（SpO2）、机械通气时间、胸部X线好转时间、ICU治疗时间，并应用SPSS19.0统计学软件进行统计分析。结果 两组患者治疗前后动脉血气分析指标比较表明，治疗后治疗组患者pH、PaO2、PaCO2及SpO2各项指标结果优于对照组，对比差异有统计学意义（P<0.05）。两组患者CPIS评分比较，治疗前两组患者CPIS评分无明显差异，治疗后治疗组在治疗第1天、第3天、第5天CPIS评分低于对照组，对比差异有统计学意义（P<0.05）。治疗组治疗后机械通气时间、胸部X线好转时间、ICU治疗时间均短于对照组，差异有统计学意义（P<0.05）。结论 纤维支气管镜吸痰治疗有助于胸外科肺癌术后VAP患者减轻感染、改善临床症状、促进康复和提高呼吸机脱机的成功率，是治疗VAP安全有效的方法，值得临床推广。 |
| 关键词: 呼吸机相关性肺炎 纤维支气管镜 肺癌根治术 重症医学 |
| DOI：10.3969/j.issn.1674-3806.2016.08.01 |
| 分类号:R 619+.4 |
| 基金项目:国家自然科学基金资助项目（编号：81560383）；广西卫计委科研课题（编号：Z2009136） |
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| The application of fiberbronchoscope in patients with ventilator-associated pneumonia after thoracic surgery |
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LIU Song-tao, SHEN Bin, LEI Tao, et al.
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The application of fiberbronchoscope in patients with ventilator-associated pneumonia after thoracic surgery
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| Abstract: |
| ［Abstract］ Objective To investigate the outcomes of fiberbronchoscope treatment in patients with ventilator-associated pneumonia(VAP) after lung radical resection, and to provide the evidence for clinical treatment.Methods Sixty patients with VAP in our hospital from December 2013 to December 2015 were collected and divided into the treatment group(n=30) and the control group(n=30) according to the different treating procedures. The treatment group received the fiberbronchoscope treatment and the control group received the routine endotracheal suction. pH, PaO2, PaCO2, SpO2, the duration of mechanical ventilation, the time of chest X-ray improvement and the length of staying in the intensive care unit(ICU) were compared between the two groups before and after the treatment. SPSS19.0 software was used for statistical analysis.Results There were no significant differences in pH, PaO2, PaCO2 and SpO2 between the two groups before the treatment, however the results had a better improvement in the treatment group than those in the control group after the treatment(P<0.05). There were no significant differences in CPIS scores between the two groups, however the CPIS scores of the treatment group were significantly lower than those of the control group 1, 3 and 5 days after the treatment(P<0.05). The duration of mechanical ventilation, the time of chest X-ray improvement, and the length of staying in ICU were significantly shorter than those of the control group(P<0.05).Conclusion Bronchoscopy helps to control the infections of ventilator associated pneumonia after the lung radical resection, improves the clinical symptoms, and promotes the rehabilitation of patients. |
| Key words: Ventilator-associated pneumonia Bronchoscopy Lung radical resection Critical care medicine |
