心脏外科术后下呼吸道感染患者采用密闭式吸痰联合纤维支气管镜的应用效果分析

Application effect of closed suction combined with fiber bronchoscopy suction on patients with lower respiratory tract infections after cardiac surgery

    摘要
  • 摘要: 目的 探讨心脏外科手术后下呼吸道感染患者采用密闭式吸痰联合纤维支气管镜吸痰法的应用效果。方法 选择2013年1月-2016年6月医院行心脏外科手术治疗后发生下呼吸道感染的113例患者临床资料进行回顾性分析;根据吸痰方法分为联合组与对照组,联合组采用密闭式吸痰联合纤维支气管镜吸痰,对照组仅采用密闭式吸痰,比较两组的临床疗效。结果 两组治疗48 h后心率、呼吸、PaO2,PaO2/FiO2水平均较治疗前显著改善,差异有统计学意义(P＜0.05);治疗48 h后,联合组心率、呼吸低于对照组,PaO2,PaO2/FiO2显著高于对照组,差异有统计学意义(P＜0.05);治疗后联合组心率、呼吸、PaO2,PaO2/FiO2改善程度显著优于对照组,差异有统计学意义(P＜0.05);联合组咳嗽咳痰消失时间、体温及白细胞恢复正常时间均显著早于对照组,差异有统计学意义(P＜0.05);治疗48 h后,两组PIP、Cdyn、WOBvent、RAW均较治疗前显著下降,差异有统计学意义(P＜0.05);治疗48 h后,联合组PIP、Cdyn、WOBvent、RAW均显著低于对照组,差异有统计学意义(P＜0.05)。结论 心脏外科手术后下呼吸道感染采用密闭式吸痰联合纤维支气管镜吸痰效果显著。

     

    Abstract: OBJECTIV To explore the application effect of closed suction combined with fiber bronchoscopy suction on patients with lower respiratory tract infections after cardiac surgery. METHODS From Jan 2013 to Jun 2016, a total of 113 patients who received the cardiac surgery and had postoperative lower respiratory tract infections were enrolled in the study, and the clinical data of the enrolled patients were retrospectively analyzed. The patients were divided into the combination group and the control group according to the sputum suction method, the combination group was treated with closed suction combined with fiber bronchoscopy suction, while the control group was only given the closed suction, and the clinical efficacy was compared between the two groups of patients. RESULTS The heart rate, RR, PaO2 level, and PaO2/FiO2 level of the two groups of patients were significantly improved after the treatment for 48 hours than before the treatment (P<0.05). The heart rate and RR of the combination group were significantly lower than those of the control group after the treatment for 48 hours; the levels of PaO2 and PaO2/FiO2 of the combination group were higher than those of the control group (P<0.05). The heart rate, RR, PaO2 level, and PaO2/FiO2 level were improved more significantly in the combination group than in the control group after the treatment (P<0.05). The time of disappearance of cough and expectoration and time of recovery of body temperature and white blood cells were significantly shorter in the combination group than in the control group, and there was significant difference (P<0.05). The PIP, Cdyn, WOBvent, and RAW of the two groups of patients were significantly lower after the treatment for 48 hours than before the treatment (P<0.05); the PIP, Cdyn, WOBvent, and RAW of the combination group were significantly lower than those of the control group after the treatment for 48 hours (P<0.05). CONCLUSION The closed suction combined with fiber bronchoscopy suction can achieve remarkable effect on the patients with lower respiratory tract infections after cardiac surgery.

     

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