目的 探讨一次性喷洒管联合电子支气管镜在重症肺炎患者接受床旁支气管肺泡灌洗术中的应用效果。方法 2023年10月至2024年10月，便利抽样法选取西安市某三级甲等综合性医院呼吸重症监护室治疗的84例重症肺炎患者为研究对象。采用简单随机化分组，对照组和观察组各42例。对照组采用电子支气管镜，观察组采用一次性喷洒管联合电子支气管镜进行肺泡灌洗术。比较两组的肺泡灌洗液回收率、不良反应发生率、病原体检出率及治疗后好转时间等。结果 观察组肺泡灌洗液回收率高于对照组（P＜0.01）；术中观察组发生血氧饱和度降低风险较低（P＜0.01），观察组发生肺出血人数多于对照组（P＜0.05）。但在支气管痉挛及误吸等不良反应发生人数方面两组差异无统计学意义（P＞0.05）。观察组病原体整体检出率较高（P＜0.05），但在一致性比较中差异无统计学意义（P＞0.05）；经抗感染治疗后，观察组在3 d内更容易出现病情好转且有效缩短好转时间（P＜0.05）。结论 对拟行床旁支气管肺泡灌洗术的辅助机械通气重症肺炎患者，采用一次性喷洒管联合电子支气管镜，可提高肺泡灌洗液回收率，降低不良反应发生，提高病原体检出率并缩短治疗后好转时间，具有临床应用与推广前景。

Objective To investigate the application effect of disposable spray tube combined with electronic bronchoscope (DST-EB) in patients with severe pneumonia undergoing bedside bronchoalveolar lavage (BAL).Methods From October 2023 to October 2024,84 patients with severe pneumonia admitted to the respiratory intensive care unit of a tertiary A general hospital in Xi’an were selected by convenience sampling, and equally divided into a control group (using the electronic bronchoscope alone) and an observation group (using DST-EB) via simple randomization,with 42 cases in each group.The bronchoalveolar lavage fluid (BALF) recovery rate,incidence of adverse reactions,pathogen detection rate,and time to improvement after treatment were compared between the groups.Results The BALF recovery rate in the observation group was higher than that in the control group (P＜0.01).During the procedure,the observation group had a lower risk of decreased oxygen saturation (P＜0.01) and a higher number of patients with pulmonary hemorrhage compared to the control group (P＜0.05).However,there were no significant differences between the groups in the number of patients experiencing adverse reactions such as bronchospasm and aspiration (P＞0.05).The overall pathogen detection rate was higher in the observation group (P＜0.05),but no significant difference was found in consistency comparisons (P＞0.05).After anti-infective treatment,patients in the observation group were more likely to show improvement within 3 days,and the time to improvement was effectively shortened (P＜0.05).Conclusions For patients with severe pneumonia on mechanical ventilation scheduled for bedside BAL,the assisted application of DST-EB by nursing staff can improve the BALF recovery rate,reduce the occurrence of adverse reactions,increase the pathogen detection rate,and shorten the time to improvement after treatment.This approach holds promise for clinical application and promotion.

R473.56

国家自然科学基金（82473215）；陕西省“三秦英才特支计划”创新创业团队