床边经纤维支气管镜支气管肺泡灌洗术在老年肺炎患者中的应用分析

摘要

目的：探讨床边经纤维支气管镜（纤支镜）支气管肺泡灌洗术在老年肺炎患者中的应用价值，为临床治疗提供参考。方法按照随机数字表法将79例老年肺炎患者分为两组，均采用常规治疗联合敏感抗生素治疗，观察组患者在此基础上加用床边经纤支镜支气管肺泡灌洗术治疗，比较两组临床疗效。结果观察组疗效优于对照组，差异具有显著性（Z＝-2.159，P＝0.031）；治疗后1小时两组患者PaO2、PaCO2、SaO2与治疗前比较差异具有显著性（P＜0.05）；治疗后6小时，12小时两组患者PaO2、PaCO2、SaO2与治疗后1小时比较，差异无显著性（P＞0.05），观察组患者治疗后PaO2、PaCO2、SaO2改善幅度大于对照组（P＜0.05）；两组患者出现的不良反应包括心律失常、气道出血、发绀、鼻咽部不适。观察组患者不良反应发生率为7.68%，对照组为27.50%，两组比较差异显著（χ2＝5.314， P＝0.021），经对症治疗及综合护理，两组患者不良反应均得以缓解。结论采用床边经纤支镜支气管肺泡灌洗术治疗老年肺炎患者效果显著，不良反应少，具有重要临床参考价值。%Objective To study the bedside by ifber bronchoscope were applied value in elderly patients with pneumonia, provide reference for clinical treatment. Method According to random number table method to 79 cases of elderly patients with pneumonia were divided into two groups, adopted conventional treatment combined sensitivity to antibiotics in both groups, observation group on the basis of used the bed by the ifber bronchoscope lavage and compared the clinical curative effect of two groups. Result The level of two groups of curative effect comparison, the difference was statistically signiifcant (Z=-2.159, P=0.031), observation group was better than control group;1 hour in the two groups after treatment of PaO2, PaCO2, SaO2 compared with before treatment, the difference was statistically signiifcant (P < 0.05), after treatment for 6 hours, 12 hours PaO2, PaCO2, SaO2 compared with 1 hour after treatment, there was no statistically signiifcant difference (P > 0.05), the observation group after treatment of PaO2, PaCO2, SaO2 improvement was greater than control group (P<0.05);two groups of adverse reactions were arrhythmia, bleeding, violet purple, nose pharynx ministry unwell, observation group was 7.68%, 27.50%in control group, control group was higher than observation group (χ2=5.314, P=0.021), after symptomatic treatment and comprehensive care, two groups of adverse reactions were eased. Conclusion In elderly patients with pneumonia with bedside ifber bronchoscope lavage treatment has good curative effect, less adverse reaction, the characteristics of clinical has important reference value.