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目的探讨感染性肺不张患者中纤维支气管镜(纤支镜)的临床应用价值。方法 82例实施机械通气的感染性肺不张患者行纤支镜吸痰和肺泡灌洗治疗2~6次,复查胸部X线了解肺不张演变情况,分别记录治疗前、每次纤支镜治疗后8 h的血气分析、临床症状缓解情况。结果 59例临床症状及血气分析指标治疗后明显改善,成功撤离呼吸机;13例实验结束时未能撤离呼吸机,但临床症状和血气指标改善;10例无效。治疗后患者氧分压(PO_2)、二氧化碳分压(PCO_2)及动脉血氧饱和度(SaO_2)均较治疗前明显改善,差异有统计学意义(P<0.05)。结论纤支镜在感染性肺不张患者中的应用可发挥重要作用,值得临床应用。
Objective To investigate the clinical value of bronchofiberscopy in patients with infectious atelectasis. Methods Eighty-two patients with infectious atelectasis who underwent mechanical ventilation were treated with bronchofibroscopy and bronchoalveolar lavage for 2 to 6 times. The chest radiographs were reviewed to understand the evolution of atelectasis. Before treatment, Blood gas analysis 8 h after treatment, the clinical symptoms of remission. Results The clinical symptoms and blood gas analysis indexes of 59 patients were significantly improved after treatment, and the ventilator was evacuated successfully. The ventilator was not evacuated at the end of the experiment, but the clinical symptoms and blood gas indexes improved; 10 patients were ineffective. After treatment, the partial pressure of oxygen (PO_2), partial pressure of carbon dioxide (PCO_2) and arterial oxygen saturation (SaO_2) were significantly improved compared with before treatment, the difference was statistically significant (P <0.05). Conclusion The application of fiberoptic bronchoscopy in patients with infectious atelectasis can play an important role and is worthy of clinical application.