Application of fiberoptic bronchoscopic irrigation and suction technique in emergency surgery for elderly patients with lung infection undergoing general anesthesia
Objective To analyze and evaluate the effect of fiberoptic bronchoscopic irrigation and suction technique applied in emergency surgery for elderly patients with lung infection.Methods Sixty cases of elderly patients who underwent emergency surgery with combined lung infection were selected.They were randomly divided into group A and group B(n=30).After tracheal intubation un-der general anesthesia,group A was suctioned with ordinary suction tubes,and group B was suctioned with fiberoptic bronchoscopic lavage technique.Blood oxygen saturation and oxygenation index at each time point of preoperative(T0),30 minutes after suction(T,),60 mi-nutes(T2),90 minutes(T3)and one hour after the end of the operation(T4)were recorded in the two groups,respiratory mechanical indexes(Pplat,Ppeak,Cdyn)at the time points of T,,T2 and T,were recorded,and the length of the operation,the awakening time as well as the inflammatory factor indexes in the preoperative,24 and 48 hours after operation were recorded,and the inflammatory factor inde-xes in the preoperative,24 hours and 48 hours after operation were recorded,and the inflammatory factor indexes in the preoperative and 48 hours after operation were recorded.The length of surgery,awakening time,as well as preoperative,24-hour and 48-hour postoperative in-flammatory factor indexes,preoperative and postoperative 24-hour and 48-hour Clinical Pulmonary Infection Score(CPIS)and 48-hour postoperative chest CT results were recorded.Results There was no statistical difference in SpO2 and PaO2/FiO2 between the two groups at the T0 time point(P＞0.05),and they increased at the T1,T2,T3 and T4 time points compared with T0,with statistical differences(P＜0.05),and the increase in group B was significantly higher than that in group A(P＜0.05);the differences in respiratory mechanics were significant between the two groups at the T,,T2 and T3(P＜0.05).There was no statistically significant difference between the two groups when comparing the awakening time and operation time(P＞0.05);the inflammatory factor indexes(PCT,TGF-β,IL-8)and CPIS scores in Group B was significantly lower than those of pre-operation at 24 and 48 hours(P＜0.05)and there was significantly signifiicunt between group A and group B(P＜0.05).The number of cases with significant improvement in pulmonary inflammation in group B was higher than that in group A at 48 hours postoperatively(P＜0.05).Conclusion The use of fiberoptic bronchoscopic irrigation and suction technique can improve pulmonary ventilation and gas exchange function,reduces the inflammatory response,and it can improve the prognosis of elderly patients with coexisting lung infections when they undergo emergency surgery.
Fiberoptic bronchoscopic suction-irrigationLung infectionElderly patientsEmergency surgery
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