目的:探讨重症脑卒中患者早期应用床边纤维支气管镜技术的临床意义.方法:将71例重症脑卒中患者随机分为治疗组36例、对照组35例.在针对原发病的专科处理外,治疗组早期应用床边纤维支气管镜技术(包括纤支镜下吸痰、支气管肺泡灌,纤支镜引导下经鼻或经口气管插管术等)处理气道情况,对照组予以常规吸痰术处理气道情况.对两组患者的肺部感染发生率、肺部感染控制时间、需行机械通气率及死亡率进行分析.结果:肺部感染发生率,治疗组为16.7%(6/36)、对照组为42.9%(15/35);肺部感染控制时间,治疗组(6.3±3.1)d、对照组(9.8±3.5)d;需行机械通气率,治疗组为8.3%(3/36)、对照组为34.3%(12/35);死亡率,治疗组为5.6%(2/36)、对照组为25.7%(9/35),两组在肺部感染发生率、肺部感染控制时间、需机械通气率及患者的死亡率方面差异均有统计学意义(均P<0.05).结论:重症脑卒中患者早期应用床边纤支镜技术能有效减少肺部感染的发生率、缩短肺部感染控制时间、降低患者的机械通气率及死亡率,是重症脑卒中患者气道处理的有效手段.%Objective: To explore the clinical significance of the early use of fiber bronchoscope for the severe stroke (SS) patients.Methods: A total of 71 SS patients were randomly divided into the treatment group (36 cases) and control group (35 cases).Besides the professional treatment for primary disease, the bedside fiber bronchoscope technologies (including aspiration of sputum through bronchoscope, bronchoalveolar lavage, nasotracheal intubation and orotacheal intubation) were used to treat the airway in the early period of the treatment group, while the patients in the control group were conducted the regular sputum suctioning.The lung infection rates, control times for lung infection, mechanical ventilation rates and death rates in the two groups were analyzed.Results: The lung infection rates of two groups were as follows, treatment group 16.7％ (6/36); control group 42.9％ (15/35).The control times for lung infection were: treatment group (63±3.1) days; control group (9.8±3.5) days.The mechanical ventilation rates of the two groups were 8.3％ (3/36) in the treatment group and 34.3％ (12/35) in the control group.The death rates of two groups were as follows: 5.6％ (2/36) in the treatment group and 25.7％ (9/35) in the control group.The differences in lung infection rate, control time of lung infection, mechanical ventilation rate and death rate of two groups had statistical significance (P＜0.05).Conclusion: The early use of fiber bronchoscope for the SS patients could drop the lung infection rate, shorten the control time of lung infection and decrease the mechanical ventilation rate and death rate, which is an effective method for the airway treatment of SS patients.
展开▼
