纤维支气管镜肺泡灌洗治疗重症肺炎伴呼吸衰竭患者的效果及对炎性反应介质因子的影响分析  

Effect of Bronchoscopic Alveolar Lavage on Severe Pneumonia with Respiratory Failure and Its Effect on Inflammatory Mediators

作　　者：张群[1] 吴长江[2] ZHANG Qun;WU Changjiang(Department of Critical Care Medicine,Wuzhong People's Hospital,Suzhou,Jiangsu Province,215100 China;Department of Critical Care Medicine,Suzhou Jiulong Hospital of Shanghai Jiaotong University School of Medicine,Suzhou,Jiangsu Province,215021 China)

机构地区：[1]苏州市吴中人民医院重症医学科,江苏苏州215100 [2]上海交通大学医学院附属苏州九龙医院重症医学科,江苏苏州215021

出　　处：《世界复合医学》2023年第2期156-159,共4页World Journal of Complex Medicine

基　　金：苏州九龙医院培育科研项目(SZJL201908)。

摘　　要：目的探讨纤维支气管镜肺泡灌洗治疗重症肺炎伴呼吸衰竭患者的治疗效果。方法选取2019年4月—2022年4月苏州市吴中人民医院收治的70例重症肺炎伴呼吸衰竭患者,以抽签法将患者随机分为两组,各35例。对照组以常规方案治疗,观察组增加纤支镜下肺泡灌洗治疗。对比两组患者疗效、血清炎性反应介质因子、血气指标变化。结果观察组治疗总有效率为91.43%(32/35),高于对照组的71.43%(25/35),差异有统计学意义(χ^(2)=4.629,P<0.05)。治疗后,观察组CRP、PCT降至(46.91±9.41)mg/L、(2.19±1.13)μg/L,低于对照组的(73.56±11.82)mg/L、(3.76±1.47)μg/L,差异有统计学意义(t=10.436、5.010,P<0.001);PaO_(2)升至(80.16±6.41)mmHg,高于对照组的(75.54±6.50)mmHg,PaCO_(2)降至(39.62±4.61)mmHg,低于对照组的(44.46±5.20)mmHg,差异有统计学意义(t=2.994、4.120,P<0.05)。结论常规治疗基础上联合纤支镜肺泡灌洗,在重症肺炎伴呼吸衰竭患者的治疗中疗效出众,可加速肺部炎症吸收,改善患者换气功能。Objective To investigate the therapeutic effect of bronchoscopic alveolar lavage on severe pneumonia with respiratory failure.Methods A total of 70 severe pneumonia patients with respiratory failure admitted to Wuzhong people's Hospital of Suzhou from April 2019 to April 2022 were selected,and the patients were randomly divided into two groups of 35 patients each by the draw method.The control group was treated with the conventional protocol,and the observation group was treated with the addition of bronchoscopic alveolar lavage.Treatment effects,serum inflammatory response mediators,and blood gas indexes changes were compared between the two groups.Results The total effective rate of observation group was 91.43%(32/35),which was higher than that of control group 71.43%(25/35),the difference was statistically significant(χ^(2)=4.629,P<0.05).After treatment,CRP and PCT in observation group decreased to(46.91±9.41)mg/L and(2.19±1.13)μg/L,which were lower than those in control group(73.56±11.82)mg/L and(3.76±1.47)μg/L,the difference was statistically significant(t=10.436,5.010,P<0.001).PaO(2) increased to(80.16±6.41)mmHg,higher than tht in the control group(75.54±6.50)mmHg.PaCO(2) decreased to(39.62±4.61)mmHg compared with(44.46±5.20)mmHg in the control group,the difference was statistically significant(t=2.994,4.120,P<0.05).Conclusion Based on conventional treatment,combined bronchoscopic alveolar lavage has an outstanding effect in the treatment of severe pneumonia with respiratory failure,which can accelerate the absorption of lung inflammation and improve the ventilation function of patients.

关 键 词：肺泡灌洗 重症肺炎 呼吸衰竭 血气指标 炎性反应 

分 类 号：R4[医药卫生—临床医学]