纤维支气管镜肺灌洗对ICU机械通气合并肺部感染患者降钙素原和C反应蛋白的影响研究  

Fiberoptic bronchoscopy lung lavage on fibrinogen and C-reactive protein C effects of calcitonin on ICU patients with mechanical ventilation combined with pulmonary infection

作　　者：孙尊鹏 葛卫星 林照 SUN Zun-peng;GE Wei-xing;LIN Zhao(ICU,Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing 211100,Jiangsu,China)

机构地区：[1]南京医科大学附属江宁医院ICU,江苏南京211100

出　　处：《川北医学院学报》2018年第5期712-714,718,共4页Journal of North Sichuan Medical College

基　　金：江苏省南京市卫生局科研项目(YKK13215)

摘　　要：目的:探讨纤维支气管镜肺灌洗对ICU机械通气合并肺部感染患者降钙素原(PCT)和C反应蛋白(CRP)的影响,为临床控制肺部感染及改善预后提供理论依据。方法:选取110例ICU机械通气合并肺部感染患者,根据数表法随机将其分为对照组和观察组,每组55例。对照组给予鼻导管吸痰、抗感染、祛痰等常规ICU治疗,观察组在对照组基础上给予纤维支气管镜肺灌洗。治疗1周后观察两组血清PCT、CRP水平和肺部感染改善效果,比较两组机械通气时间、肺部感染控制时间及ICU住院时间。结果:两组治疗1周后血清PCT、CRP均有显著下降(P <0. 05),但观察组治疗1周后上述炎性因子表达下降更为显著(P <0. 05);观察组ICU机械通气时间、肺部感染控制时间及ICU住院时间均低于对照组,差异具有统计学意义(P <0. 05);观察组治疗过程中未出现心率异常、大咯血等严重并发症,治疗总有效率94. 55%,对照组81. 82%,差异具有统计学意义(P <0. 05)。结论:纤维支气管镜肺灌洗可显著降低ICU机械通气合并肺部感染患者血清PCT、CRP表达和控制肺部感染,临床治疗效果显著,安全性好,是节约医疗开支的有效手段。Objective： To investigate the effects of bronchoscopic lung lavage on calcitonin （PCT） and C reactive protein （CRP） in the patients with pulmonary infection in critical care unit （ICU）,and to provide a theoretical basis for the clinical control of pulmonary infection and the improvement of prognosis. Methods： 110 cases of ICU mechanical ventilation combined with pulmonary infection were selected.The patients were randomly divided into the control group and the observation group according to the table method,and 55 cases in each group.The control group was given conventional ICU treatment including nasal catheter suction,anti infection,expectorant and so on.The observation group was given bronchoscopy lung lavage on the basis of the control group.After treatment of 1 week,the serum PCT and CRP levels and the improvement effect of pulmonary infection were observed in the two groups.The duration of mechanical ventilation,the time of infection control and the length of stay in ICU were compared between the two groups. Results： After the treatment of 1 week, the serum PCT and CRP were significantly decreased （ P 〈0.05）, but the expression of the above inflammatory factors decreased more significantly in the observation group （ P 〈0.05）. The time of ICU mechanical ventilation, the control time of pulmonary infection and the time of hospitalization of ICU in the observation group were all lower than those of the control group, and the differences were statistically significant （ P 〈0.05）. In the observation group, there were no serious complications such as abnormal heart rate and large hemoptysis during the treatment, and the total effective rate was 94.55% （52/55）.Which was higher than that of the control group 81.82%（45/55）, and the difference was statistically significant （ P 〈0.05）. Conclusion： Bronchoscopic lung lavage can significantly reduce the expression of serum PCT and CRP and control pulmonary infection in patients with ICU mechanical ventilation with pulm

关 键 词：机械通气 肺部感染 纤维支气管镜 降钙素原 C反应蛋白 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]