【摘要】 目的探讨纤支镜支气管肺泡灌洗(BAL)在COPD机械通气患者中的应用效果与安全性。方法选取在我院住院COPD患者90例,分为观察组和对照组,在综合治疗的基础上观察组给予纤支镜BAL,对照组给予普通灌洗,比较两者的治疗效果及安全性。结果观察组在气道阻力、机械通气时间、脱机成功率及抗生素应用时间方面明显优于对照组,(P<0.05)。观察组PaO2、PaCO2指标明显优于对照组,(P<0.05)。操作中有2例出现轻度的一过性低氧血症,1例发生窦性心动过速,未发生严重心律失常及血压明显下降等。结论 BAL技术操作较简单,创伤小,可反复进行,在COPD的诊疗中能明确病原菌并指导治疗,改善有效通气,具有很大的应用价值。更多还原

【Abstract】 Objective To investigate the effect and safety of broncho alveolar lavage in the treatment of COPD patients who were received mechanical ventilation.Methods 90 COPD patients were randomly divided into the observation group and the control group.On the basis of conventional therapy,the observation group received broncho alveolar lavage,and the control group received normal lavage.The effect and safety were compared between the two groups.Results The improvement of airway resistance,time of mechanical ventilation and antibiotics use,achievement ratio of off-line was more pronounced in the observation group than in the control group with significant difference(P<0.05).The indexes of PaO2 and PaCO2 were superior in the observation group than those of the control group with significant difference(P<0.05).There were 2 cases with ephemeral hypoxemia,1 case with sinus tachycardia and no serious cardiac arrhythmia and dramatic decline of blood pressure reported.Conclusion Broncho alveolar lavage has the advantages of easy-control,mini trauma and repeatability.It can identify the pathogenic bacteria and improve the effective ventilation,so it is worth to be applied and promoted in clinical practice.更多还原