【摘要】 目的探讨机械通气必要时联合支气管肺泡灌洗(BAL)在ICU治疗呼吸衰竭的作用。方法选择常规治疗后病情缓解不明显的重症呼吸衰竭患者31例,建立人工气道行机械通气治疗,对机械通气24 h后,低氧血症纠正不理想、气道压力仍偏高、痰多者,应用生理盐水加氨溴索及爱全乐经纤支镜行BALF,清除呼吸道痰栓,每天1次,连续3d。结果31例患者中,27例通气24 h,经支气管肺泡灌洗后,气道压下降(P<0.05),临床症状好转,缺氧及二氧化碳潴留得到改善,病源菌得到明确,成功脱机出院。结论在机械通气基础上结合支气管肺泡灌洗是治疗呼吸衰竭安全有效的措施,值得推广。更多还原

【Abstract】 Objective To discuss the roles of mechanical ventilation associated with bronchoalveolar lavage when necessary in patients with severe respiratory failure.Methods Thirty-one patients with severe respiratory failure were treated by mechanical ventilation.The patiets with hypoxemia treated by mechanical ventilation after routine 24h,were perform bronchoalveolar lavage by fiberoptic bronchoscopy with saline plus ambroxol hydrochloride and Atrovent,with fluid 150-200ml/d.Results In 31 patients with severe respiratory failure,27 patients were performed bronchoalveolar lavage.The airway pressure descended gradually.The clinical symptoms were improved.The level of PaO₂ was increased,and PaCO₂ was decreased after 24h.Pathogen was definited.All of 27 patients discharged.Conclusion Mechanical ventilation associated with bronchoalveolar lavage is effective measure to treat severe respiratory failure.Bronchoalveolar lavage by fiberoptic bronchoscopy in ICU is safe.更多还原