【摘要】 目的：探究高频振荡排痰联合纤维支气管镜肺泡灌洗治疗ICU机械通气重症肺部感染患者的价值。方法：选取肇庆市高要区人民医院2020年7月─2022年5月收治的100例ICU机械通气重症肺部感染患者，按照治疗方式的不同，将采取高频振荡排痰联合纤维支气管镜肺泡灌洗治疗的48例患者纳入观察组，采取常规叩背排痰联合纤维支气管镜肺泡灌洗治疗的52例患者纳入对照组。比较两组临床效果、呼吸功能指标、血气分析指标。结果：观察组总有效率较对照组高，差异有统计学意义（P<0.05）。治疗1周后，两组气道峰值吸气压力（PIP）、气道阻力（RAW）、呼吸做功（WOB）均较治疗前降低，动态肺顺应性（CLdyn）均较治疗前升高，差异均有统计学意义（P<0.05）；治疗1周后，观察组PIP、RAW、WOB均较对照组低，CLdyn较对照组高，差异均有统计学意义（P<0.05）。治疗1周后，两组血氧分压（PaO2）、动脉血氧饱和度（SaO2）均高于治疗前，动脉血二氧化碳分压（PaCO2）均低于治疗前，且观察组均优于对照组，差异均有统计学意义（P<0.05）。结论：利用高频振荡排痰联合纤维支气管镜肺泡灌洗治疗ICU机械通气重症肺部感染患者效果显著，可促进痰液有效排出，改善患者呼吸功能及血气分析指标。更多还原

【Abstract】 Objective: To explore the value of high frequency oscillatory expectoration combined with fiberoptic bronchoscopic alveolar lavage in the treatment of ICU patients withsevere pulmonary infection undergoing mechanical ventilation. Method: A total of 100 patients with severe pulmonary infection undergoing mechanical ventilation in the ICU who were admitted to Zhaoqing Gaoyao District People’s Hospital from July 2020 to May 2022 were selected. According to the different treatment methods, 48 patients who were treated with high frequency oscillatory expectoration combined with fiberoptic bronchoscopic alveolar lavage were included in the observation group, and 52 patients who were treated with conventional expectoration with percussion on back combined with fiberoptic bronchoscopic alveolar lavage were included in the control group. The clinical effects, respiratory function indicators, and blood gas analysis indicators of the two groups were compared. Result: The total effective rate in the observation group was higher than that in the control group, the difference was statistically significant(P<0.05). After 1 week of treatment, the peak inspiratory pressure(PIP), resistance in airways(RAW),and work of breathing(WOB) of the two groups decreased compared to before treatment, while the dynamic lung compliance(CLdyn)increased compared to before treatment, the differences were statistically significant(P<0.05); after 1 week of treatment, the PIP, RAW,and WOB in the observation group were lower than those in the control group, and the CLdyn was higher than that in the control group, the differences were statistically significant(P<0.05). After 1 week of treatment, the partial pressure of blood oxygen(PaO2) and arterial oxygen saturation(SaO2) in both groups were higher than those of before treatment, while the partial pressure of arterial carbon dioxide(PaCO2)were lower than those of before treatment, the observation group were better than the control group, the differences were statistically significant(P<0.05). Conclusion: High frequency oscillatory expectoration combined with fiberoptic bronchoscopic alveolar lavage has a significant effect in the treatment of ICU patients with severe pulmonary infection undergoing mechanical ventilation. It can promote the effective discharge of sputum and improve the respiratory function and blood gas analysis indicators of patients.更多还原