经气管切开术患者的 BAL 预防肺炎：一项临床试验研究。
BAL for pneumonia prevention in tracheostomy patients: A clinical trial study.
机构信息
Amir K Vejdan, Assistant Professor of General Surgery, University of Medicine, Master of Burn and General Surgery Wards, Imam Reza Hospital, Birjand, Iran.
Maliheh Khosravi, Resident of Anesthesiology, Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Pak J Med Sci. 2013 Jan;29(1):148-51. doi: 10.12669/pjms.291.1971.
OBJECTIVE
To evaluate the role of flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) on pneumonia prevention of tracheostomy patients in intensive care unit.
METHODOLOGY
This clinical trial was conducted on 67 head-injury patients who needed tracheostomy. The eligible patients were divided into two groups of different methods for removing the airway secretions. In intervention group, FB and BAL was added to routine conventional methods for airway clearance. Patients were followed for signs and symptoms of pneumonia. Results : The risk of nosocomial pneumonia decreased from 35% to 14% in intervention group. The days of hospital stay were significantly reduced with bronchoscopic method.
CONCLUSIONS
Flexible Bronchoscopy is recommended to all ICU admitted patients that have tracheostomy tube and high volume of secretion in their airways. It can not only prevent the pneumonia formation decrease the morbidity and mortality rate but it can even shorten the ICU stay time and consequently reduce the costs of treatment.
目的
评估纤维支气管镜（FB）和支气管肺泡灌洗（BAL）在预防 ICU 气管切开患者肺炎中的作用。
方法
本临床试验纳入了 67 例需要气管切开的颅脑损伤患者。符合条件的患者被分为两组，采用不同的方法清除气道分泌物。在干预组中，FB 和 BAL 被添加到常规的气道清除常规方法中。对患者进行肺炎的体征和症状监测。结果：干预组医院获得性肺炎的风险从 35%降至 14%。支气管镜方法显著减少了住院天数。
结论
推荐所有 ICU 中存在气管切开管和大量气道分泌物的患者使用纤维支气管镜。它不仅可以预防肺炎的形成，降低发病率和死亡率，甚至可以缩短 ICU 住院时间，从而降低治疗费用。
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