临床荟萃 ›› 2026, Vol. 41 ›› Issue (9): 807-811.doi: 10.3969/j.issn.1004-583X.2026.09.004

• 论著 • 上一篇    下一篇

床旁超声指导下胸部物理治疗联合纤维支气管镜吸痰在重症机械通气患者气道廓清中的应用效果

刘佳, 刘富康, 王晓庆()   

  1. 天津市人民医院 重症医学科, 天津 300192
  • 收稿日期:2026-04-02 出版日期:2026-09-20 发布日期:2026-09-17
  • 通讯作者: 王晓庆 E-mail:wangxiaoqing@umc.net.cn
  • 基金资助:
    天津市人民医院科研项目——床旁超声指导下的胸部物理治疗对机械通气患者气道廓清的作用(2023YJHL030)

Effect of bedside ultrasound-guided chest physiotherapy combined with fiberoptic bronchoscopy suction on airway clearance in critically ill patients receiving mechanical ventilation

Liu Jia, Liu Fukang, Wang Xiaoqing()   

  1. Department of Critical Care Medicine, Tianjin Union Medical Center, Tianjin 300192, China
  • Received:2026-04-02 Online:2026-09-20 Published:2026-09-17
  • Contact: Wang Xiaoqing E-mail:wangxiaoqing@umc.net.cn

摘要:

目的 探讨床旁超声指导下胸部物理治疗联合纤维支气管镜吸痰在重症机械通气患者气道廓清中的应用效果。方法 前瞻性选取2023年12月-2025年3月于天津市人民医院就诊的100例重症机械通气患者。按照随机数字表法将患者分为观察组(50例)与对照组(50例)。对照组采用常规气道廓清措施,观察组实施床旁超声指导下胸部物理治疗联合纤维支气管镜吸痰。对比两组氧合指标、肺部超声评分、气道廓清效果、临床结局和不良反应。结果 治疗后,两组氧合指数均上升,肺部超声评分均下降。观察组氧合指数均显著高于对照组,肺部超声评分均显著低于对照组(P<0.05)。治疗后,观察组气道分泌物清除量和排痰效果评分均显著高于对照组(P<0.05)。观察组机械通气时间和重症监护室住院时间均显著低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论 床旁超声引导下联合气道廓清方案可有效改善重症机械通气患者氧合,促进肺复张,缩短机械通气时间,且安全性良好,值得临床推广。

关键词: 超声检查, 物理治疗方法, 支气管镜检查, 呼吸, 人工, 气道管理

Abstract:

Objective To investigate the effect of bedside ultrasound-guided chest physiotherapy combined with fiberoptic bronchoscopy suction on airway clearance in critically ill patients receiving mechanical ventilation. Methods A total of 100 critically ill patients receiving mechanical ventilation who were treated at Tianjin Union Medical Center from December 2023 to March 2025 were prospectively enrolled. Using a random number table, the patients were divided into an observation group (50 cases) and a control group (50 cases). The control group received conventional airway clearance measures, whereas the observation group received bedside ultrasound-guided chest physiotherapy combined with fiberoptic bronchoscopy suction. Oxygenation indicators, lung ultrasound scores, airway clearance efficacy, clinical outcomes, and adverse reactions were compared between the two groups. Results After treatment, oxygenation index increased and lung ultrasound scores decreased in both groups. The observation group had significantly higher oxygenation index values and significantly lower lung ultrasound scores than the control group (P<0.05). After treatment, the observation group had significantly greater airway secretion clearance and higher sputum expectoration effectiveness scores than the control group (P<0.05). The observation group had significantly shorter mechanical ventilation time and intensive care unit length of stay than the control group (P<0.05). The incidence of adverse reactions was lower in the observation group than in the control group (P<0.05). Conclusion A bedside ultrasound-guided combined airway clearance strategy can effectively improve oxygenation, promote lung recruitment, shorten the duration of mechanical ventilation in critically ill patients receiving mechanical ventilation, and is safe and worthy of clinical promotion.

Key words: ultrasonography, physical therapy modalities, bronchoscopy, respiration, artificial, airway management

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