纤维支气管镜吸痰辅助治疗对重症肺部感染患者的疗效及炎症标志物水平的影响分析  

Therapeutic effect of adjuvant sputum suction by fiberoptic bronchoscopy on patients with severe pulmonary infections and influence on levels of inflammatory markers

作　　者：王巍[1] 鹿翠香[1] 何平[1] 刘丽敏[1] 吕华[1] 

机构地区：[1]大庆龙南医院呼吸内科,黑龙江大庆163453

出　　处：《中华医院感染学杂志》2017年第22期5083-5086,共4页Chinese Journal of Nosocomiology

基　　金：黑龙江省医学科研基金资助项目(A2010244)

摘　　要：目的分析纤维支气管镜吸痰辅助治疗对重症肺部感染患者的疗效及炎症标志物水平的影响,为临床抗感染治疗工作提供客观依据。方法选取2015年9月-2016年9月的重症肺部感染患者102例作为研究对象,根据治疗方式将其分为两组,应用纤维支气管镜吸痰联合常规抗感染治疗的58例患者设为试验组,仅应用常规抗感染治疗的44例患者设为对照组,观察两组患者的临床疗效,比较两组患者体温恢复正常时间、血象恢复正常时间、肺部症状消失时间、机械通气时间、住院时间等治疗指标,比较两组患者治疗前后的血清脂联素(APN)、降钙素原(PCT)、巨噬细胞炎症蛋白-1α(MIP-1α)等炎症标志物水平,比较两组患者治疗前后的血管紧张素转换酶(ACE)、一氧化氮(NO)、胆碱酯酶(ChE)等病情严重程度标志物。结果试验组的临床有效率为87.9%高于对照组的63.6%,疗效分布优于对照组,两组比较差异有统计学意义(P<0.05);试验组患者的体温恢复正常时间、血象恢复正常时间、肺部症状消失时间、机械通气时间、住院时间等治疗指标均低于对照组,两组比较差异均有统计学意义(P<0.05);试验组患者治疗后血清PCT、MIP-1α水平显著低于对照组,血清APN水平显著高于对照组,两组比较差异均有统计学意义(P<0.05);试验组患者治疗后的血清ACE、NO水平显著低于对照组,血清ChE水平显著高于对照组,两组比较差异均有统计学意义(P<0.05)。结论在重症肺部感染中应用纤维支气管镜吸痰进行辅助治疗,能够提高治疗效果、改善治疗指标、降低全身性炎症反应程度和疾病严重程度,有利于提高救治成功率和改善患者预后。OBJECTIVE To observe the therapeutic effect of adjuvant sputum suction by fiberoptic bronchoscopy on patients with severe pulmonary infections and influence on levels of inflammatory markers so as to provide objec-tive basis for clinical treatment of the infections.METHODS A total of 102 patients with severe pulmonary infec-tions who were treated in the hospital from Sep 2015 to Sep 2016 were recruited as the study objects and divided into two groups according to the treatment approach.58 patients who were treated with sputum suction by fiber-optic bronchoscopy combined with conventional anti-infection therapy were assigned as the observation group,and 44 patients who were only treated with conventional anti-infection therapy were set as the control group.The clini-cal therapeutic effect of the two groups of patients was observed;the time of recovery of body temperature,time of recovery of hemogram indexes,time of disappearance of pulmonary symptoms,mechanical ventilation duration and length of hospital stay were compared between the two groups of patients;the levels of inflammatory markers such as serum adiponectin（APN）,procalcitonin（PCT）and macrophage inflammatory protein-1α（MIP-1α）were compared between the two groups of patients before and after the treatment;the markers for severity of illness condition such as angiotensin - converting enzyme（ACE）,nitric oxide（NO）and cholinesterase（ChE）were compared between the two groups of patients before and after the treatment.RESULTS The effective rate of clinical treatment of the observation group was 87.9%,significantly higher than 63.6% of the control group（P〈0.05）. The time of recovery of body temperature,time of recovery of hemogram indexes,time of disappearance of pulmo-nary symptoms,mechanical ventilation duration and length of hospital stay were significantly shorter in the obser-vation group than in the control group（P〈0.05）.The levels of serum PCT and MIP-1α of the observation group were significantly lower than those of t

关 键 词：纤维支气管镜 辅助治疗 重症肺部感染 疗效观察 炎症标志物 

分 类 号：R563.1[医药卫生—呼吸系统]