纤维支气管镜肺泡灌洗对重症肺炎伴呼吸衰竭患者临床疗效、肺功能及炎性因子的影响  

Clinical Efficacy of Bronchofiberscope Alveolar Lavage in Treatment of Patients with Severe Pneumonia Associated by Respiratory Failure and Its Effects on Pulmonary Function and Inflammatory Factors

作　　者：雷雪超 李峰 梁国彩 LEI Xue-chao;LI Feng;LIANG Guo-cai(Department of Respiratory and Critical Care Medicine,the First Hospital Affiliated to Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院呼吸与危重症医学科,河北张家口075000

出　　处：《解放军医药杂志》2022年第1期69-71,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫健委课题项目(20170815)。

摘　　要：目的分析纤维支气管镜肺泡灌洗(BAL)治疗重症肺炎伴呼吸衰竭患者的效果及对肺功能、炎性因子的影响。方法选取本院2017年6月—2019年7月收治的76例重症肺炎伴呼吸衰竭患者,根据治疗方法的不同均分为观察组(传统治疗联合BAL治疗)和对照组(传统治疗),比较2组临床疗效,治疗前后肺功能指标、炎性因子、血气分析指标变化情况。结果治疗后,观察组总有效率明显高于对照组(P<0.05)。治疗后2组最大呼气流量、第一秒用力呼气容积、第一秒用力呼气容积占用力肺活量比值、高迁移率族蛋白B-1、可溶性髓系细胞触发受体-1、C反应蛋白、二氧化碳分压、血氧饱和度、血氧分压均较治疗前改善,且观察组上述指标改善程度更明显(P<0.05,P<0.01)。结论BAL治疗重症肺炎伴呼吸衰竭患者效果佳,可改善患者肺功能和血气分析指标,降低炎性因子水平。Objective To analyze clinical efficacy of bronchofiberscope alveolar lavage(BAL)in treatment of patients with severe pneumonia associated by respiratory failure and its effects on pulmonary function and inflammatory factors.Methods A total of 76 patients with severe pneumonia associated by respiratory failure admitted between June 2017 and July 2019 were divided into observation group(traditional treatment combined with BAL)and control group(traditional treatment)according to different therapeutic methods.Clinical efficacy,changes of pulmonary function indexes,inflammatory factors and blood gas analysis indexes before and after treatment were compared between two groups.Results After treatment,the total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,values of peak expiratory flow,forced expiratory volume in the first second,the ratio of forced expiratory volume in the first second to forced vital capacity,high mobility group protein B-1,soluble myeloid cell trigger receptor-1,C-reactive protein,carbon dioxide partial pressure,blood oxygen saturation and blood oxygen partial pressure were significantly improved compared with those before treatment in two groups,and improvement degrees of the above indexes in observation group were more obvious(P<0.05,P<0.01).Conclusion BAL may achieve good therapeutic effect,improve pulmonary function and blood gas analysis indexes and reduce the levels of inflammatory factors in treatment of patients with severe pneumonia associated by respiratory failure.

关 键 词：呼吸功能不全 肺炎 支气管肺泡灌洗 第一秒用力呼气容积 C反应蛋白 二氧化碳分压 

分 类 号：R563.8[医药卫生—呼吸系统]