目的：探讨床旁支气管肺泡灌洗联合机械通气治疗重症颅脑损伤所致肺不张的临床治疗效果。方法所有24例病例在纤维支气管镜下进行支气管肺泡灌洗，清除其气道内的阻塞物，并在此基础上加以机械通气进行治疗。实时监测患者的生命体征及动脉血气分析情况，比较分析所有患者在手术前后的各项指标及临床情况。结果手术治疗后，患者的动脉血氧分压迅速上升、二氧化碳分压下降，同手术前相比差异有统计学意义（P＜0．05），患者呼吸衰竭的症状得以纠正。通过对患者的生命体征情况进行实时监测发现，患者的各项生命体征指标并没有随着手术的进行而出现较大的变动。经1～5次治疗后，20例肺不张患者得到完全复张。其中4例患者因原发病病情严重，换气功能及通气功能均严重障碍，呼吸衰竭难以纠正而死亡。结论床旁支气管肺泡灌洗加机械通气联合治疗重型颅脑损伤所致肺不张效果明显，治疗过程简单快速，并没有给患者造成较大的创伤，值得在临床上推广应用。%Objective To research the clinical effect of bedside bronchoalveolar lavage combined with mechanical ventilation in the treatment of pulmonary atelectasis caused by severe craniocerebral injury. Methods All 24 cases were performed bronchoalveolar lavage in fiberoptic bronchoscopy, and cleared the obstruction of the airway.And on this basis, combined with mechanical ventilation.The vital signs and arterial blood gas were monitored.Compared and analyzed all patients'indicators and clinical situation before and after operation.Results After the operation treatment, arterial oxygen partial pressure of the patients was rising rapidly, and partial pressure of carbon dioxide decreased, compared with the preoperative, the difference was statistically significant ( P <0.05 ) , and respiratory failure in patients was corrected. Through real-time monitoring in the vital signs of patients, and founded along with the ongoing operation, the vital signs in patients didn't appear large changes.After 1~5 times after treatment, 20 cases of pulmonary atelectasis patients obtained complete reexpansion.And because of the illness of primary disease seriously, the function of ventilation and ventilation function of 4 cases were serious obstacles, they were difficult to correct respiratory failure and died. Conclusions Bedside bronchoalveolar lavage combined with mechanical ventilation in the treatment of pulmonary atelectasis caused by severe craniocerebral injury has obvious effect.The treatment process is simple and quick, and did not cause great trauma, which is worthy of popularization and application in clinic.
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