Observation on the therapeutic effect of bedside bronchoscopy sputum aspiration combined with mechanical ventilation in patients with chronic obstructive pulmonary disease
Objective To observe the effect of bedside bronchoscopy sputum aspiration combined with mechanical ventilation in patients with chronic obstructive pulmonary disease.Methods 80 patients with chronic obstructive pulmonary disease were divided into a control group(n=40)and an observation group(n=40)according to random numerical table.The control group received mechanical ventilation treatment,and the observation group received bedside bronchoscopy sputum aspiration+mechanical ventilation treatment.Both groups were compared in terms of clinical efficacy,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL),IL-8,C-reactive protein(CRP)],blood gas parameters[arterial partial pressure of oxygen(PaO2)and arterial partial pressure of carbon dioxide(PaCO2)],fever reduction time and mechanical ventilation mechanical ventilation withdrawal time,respiratory mechanical parameters[peak inspiratory pressure(PIP),airway resistance(RAW),dynamic compliance(Cdyn),work of breathing(WOB)].Results After treatment,the observation group had TNF-α of(4.15±0.64)ng/L,IL-6 of(21.98±3.62)pg/ml,IL-8 of(25.24±4.31)μg/L,and CRP of(72.22±9.51)mg/L,which were significantly lower than(7.04±1.78)ng/L,(54.54±6.55)pg/ml,(49.15±8.78)μg/L,and(101.31±11.21)mg/L in the control group(P<0.05).After treatment,the observation group had higher PaO2 of(77.81±14.06)mm Hg(1 mm Hg=0.133 kPa)than(68.75±12.86)mm Hg in the control group,and lower PaCO2 of(41.06±4.25)mm Hg than(48.69±5.13)mm Hg in the control group(P<0.05).In the observation group,the fever reduction time was(2.26±0.52)d and the mechanical ventilation weaning time was(5.26±1.23)d,which were shorter than(3.68±1.03)and(8.25±2.12)d in the control group(P<0.05).After treatment,the observation group had PIP of(16.33±2.16)cm H2O(1 cm H2O=0.098 kPa),Raw of(8.20±0.45)cm H2O/(L·s)and WOB of(0.34±0.17)J/L,which were significantly lower than(23.42±2.55)H2O,(11.35±0.50)cm H2O/(L·s)and(0.50±0.30)J/L in the control group;Cdyn of(36.15±7.24)ml/cm H2O in the observation group was higher than(27.20±6.46)ml/cm H2O in the control group(P<0.05).The total effective rate of 97.50%in the observation group was significantly higher than75.00%in the control group(P<0.05).Conclusion Bedside bronchoscopy sputum aspiration combined with mechanical ventilation can improve clinical efficacy,improve inflammatory factors,blood gas parameters,respiratory mechanics parameters,and shorten recovery time for patients with chronic obstructive pulmonary disease.It can be promoted in clinical practice.
万方数据
维普
