Clinical efficacy of fiberoptic bronchoscopy in the treatment of severe ventilator-associated pneumonia and its influence on respiratory mechanics
纤维支气管镜辅助治疗重症呼吸机相关性肺炎的临床疗效以及对呼吸力学指标的影响

摘要

目的 探讨纤维支气管镜辅助治疗重症呼吸机相关性肺炎的疗效。方法 回顾性选取2020年2月~2021年2月本院重症呼吸机相关性肺炎患者60例，依据治疗方法分为纤维支气管镜辅助治疗组（辅助治疗组）、常规治疗组两组，各30例，统计分析两组临床疗效、疗效指标、呼吸力学指标。结果 与常规治疗组73.33%（22/30）比较，辅助治疗组患者的总有效率93.33%（28/30）较高（χ2=4.320，P<0.05）。与常规治疗组比较，辅助治疗组患者的机械通气时间较短（P<0.05），肺部感染控制时间较短（P<0.05），RICU停留时间较短（P<0.05），治愈时间较短（P<0.05）。治疗前，与常规治疗组比较，辅助治疗组患者的Raw类似（P>0.05），PIP类似（P>0.05），WOB类似（P>0.05），Cdyn类似（P>0.05），治疗后，与常规治疗组比较，辅助治疗组患者的Raw较低（P<0.05），PIP较低（P<0.05），WOB较低（P<0.05），Cdyn较高（P<0.05）；与治疗前比较，两组患者治疗后的Raw均较低（P<0.05），PIP均较低（P<0.05），WOB均较低（P<0.05），Cdyn均较高（P<0.05）。结论 重症呼吸机相关性肺炎治疗中，与常规治疗相比，纤维支气管镜辅助治疗具有更显著的疗效。

Abstract

Objective To investigate the efficacy of fiberoptic bronchoscopy in the treatment of severe ventilator-associated pneumonia.
Methods: Retrospectively selected 60 patients with severe ventilator-associated pneumonia in our hospital from February 2020 to February 2021, and divided them into two groups according to the treatment methods: fiberoptic bronchoscopy adjuvant therapy group (adjuvant therapy group) and conventional therapy group. 30 cases, the clinical efficacy, efficacy indicators and respiratory mechanics indicators of the two groups were statistically analyzed.
Results: Compared with 73.33% (22/30) in the conventional treatment group, the total effective rate in the adjuvant treatment group was 93.33% (28/30) higher (χ2=4.320, P<0.05). Compared with the conventional treatment group, the adjuvant treatment group had shorter mechanical ventilation time (P<0.05), shorter pulmonary infection control time (P<0.05), shorter RICU stay time (P<0.05), and shorter recovery time (P<0.05). Before treatment, compared with the conventional treatment group, the patients in the adjuvant treatment group had similar Raw (P>0.05), PIP (P>0.05), WOB (P>0.05), and Cdyn (P>0.05), and after treatment, were similar to Compared with the conventional treatment group, the patients in the adjuvant treatment group had lower Raw (P<0.05), lower PIP (P<0.05), lower WOB (P<0.05), and higher Cdyn (P<0.05); compared with those before treatment , the two groups of patients after treatment had lower Raw (P<0.05), lower PIP (P<0.05), lower WOB (P<0.05), and higher Cdyn (P<0.05).
Conclusion  : In the treatment of severe ventilator-associated pneumonia, compared with conventional treatment, fiberoptic bronchoscopy adjuvant therapy has a more significant effect.