肺复张治疗在防止纤维支气管镜检查后肺泡塌陷中的作用和临床价值

摘要

目的 探讨肺复张治疗在防止纤维支气镜检查后肺泡塌陷中的作用和临床价值.方法 选择2014年4月至2017年4月于我院行深低温停循环主动脉夹层术后并发低氧血症的患者60例,按照随机数字表法分为两组,每组30例.对照组行常规纤维支气管镜检查和呼气末正压通气治疗,试验组在此基础上应用肺复张法进行治疗.比较两组治疗前、后的呼吸循环的各项参数变化以及机械通气所用的时间.结果 两组治疗前各项参数比较,差异均无统计学意义(P＞0.05);治疗后试验组氧合指数和机械通气时间与对照组相比,差异有统计学意义(P＜0.05);两组动脉二氧化碳分压与潮气量治疗前、后差异无统计学意义(P＞0.05);两组各项循环系统指标趋于稳定,无明显变化(P＞0.05).结论 使用支气管镜对主动脉夹层术后并发低氧血症进行检查后,应用肺复张法进行治疗,可以改善患者的氧合指数,减少机械通气.%Objective To investigate the effect of lung recruitment maneuver on alveolar collapse after fiber support bronchoscopy,and to evaluate its clinical value.Methods Since April 2014 and April 2017 in underwent deep hypothermia and stop of 60 cases of hypoxemia in patients with postoperative aortic circulation as the research object,according to the random number distribution method.The average score of the two groups,each group with 30 cases in each.The control group was treated with conventional fiber bronchoscopy and end expiratory positive pressure ventilation in the treatment,observation group patients on the basis of the application of lung recruitment method to carry on the treatment.Observation compared two groups of patients with lung recruitment maneuver and respiration and circulation of the parameter variations and mechanical ventilation in time.Results Two groups of patients with treatment of the parameters,the difference was not statistically significant (P ＞0.05);after treatment,observation group of patients with oxygen synthetic index and mechanical ventilation time and the control group was significant difference compared with statistical significance(P ＜ 0.05);and two groups of patients with arterial carbon dioxide into change of pressure and tidal volume before and after the treatment were not significant,no statistical significance(P ＞ 0.05).Two groups of patients with the circulatory system index tends to be stable,no significant change (P ＞0.05).Conclusion The use of bronchoscopy in patients with aortic dissection after the examination of hypoxia,application of lung recruitment maneuver method for treatment,can improve the patient's oxygenation index,reduce the time of mechanical ventilation in patients with.