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目的探讨纤维支气管镜(简称纤支镜)灌洗在重症监护室(intensive care unit,ICU)机械通气患者中的临床应用价值。方法64例ICU机械通气的患者随机分为对照组和灌洗组各32例。两组均给予全身抗感染、雾化吸入等对症支持治疗。灌洗组予纤支镜肺泡灌洗治疗,对照组常规吸痰治疗。两组进行治疗疗效比较。结果两组有效率、治愈率比较差异有统计学意义(P<0.05);灌洗组血气变化、肺部感染控制窗时间、机械通气时间及平均住院时间优于对照组(P<0.05);灌洗组成功撤机、器官衰竭及院内死亡例数低于对照组(P<0.05)。结论ICU机械通气患者行纤支镜肺泡灌洗可改善通气和预后,是安全、有效的,值得临床推广。
Objective To investigate the clinical value of bronchofibroscopy (LBF) lavage in intensive care unit (ICU) patients with mechanical ventilation. Methods 64 patients with ICU mechanical ventilation were randomly divided into control group and lavage group of 32 cases. Both groups were given systemic anti-infection, aerosol inhalation and other symptomatic and supportive treatment. Lavage group bronchoscopy bronchoalveolar lavage treatment, control group conventional suction treatment. The two groups compared the efficacy of treatment. Results The effective rate and the cure rate of the two groups were significantly different (P <0.05). The changes of blood gas, time of lung infection control window, duration of mechanical ventilation and average length of hospital stay in the lavage group were better than those in the control group (P <0.05). The number of successful weaning, organ failure and hospital death in lavage group was lower than that in control group (P <0.05). Conclusion ICU patients with bronchiolitis and bronchoalveolar lavage can improve ventilation and prognosis in patients with mechanical ventilation, which is safe and effective and worthy of clinical promotion.