支气管镜下肺泡灌洗对老年支气管扩张并感染患者肺功能、血气指标及炎症反应的影响  

Effect Of Bronchoscopic Alveolar Lavage On Pulmonary Function,Blood Gas Indexes And Inflammatory Response In Elderly Patients With Bronchiectasis And Infection

作　　者：菅利萍 王石磊[2] 王华启[3] JIAN Liping;WANG Shilei;WANG Huaqi(Department of Internal Medicine,the Third People's Hospital of Kaifeng(formerly the First People's Hospital of Fuxiang District,Kaifeng City),Kaifeng Henan 475000,China;Third Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China;Department of Respiratory Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]开封市第三人民医院(原开封市祥符区第一人民医院)内科,河南开封475000 [2]郑州大学第一附属医院呼吸与危重症医学三科,河南郑州450000 [3]郑州大学第一附属医院呼吸内科,河南郑州450000

出　　处：《临床研究》2023年第10期19-22,共4页Clinical Research

摘　　要：目的探究支气管镜下肺泡灌洗对老年支气管扩张并感染患者肺功能、血气指标及炎症反应的影响。方法研究选择开封市第三人民医院2021年2月至2022年2月收治的202例支气管扩张合并感染的老年患者作为研究的对象,按照随机数字表将202例患者分为试验组和对照组,每组101例。对照组进行常规保守治疗,试验组在此基础上进行支气管镜下肺泡灌洗。记录两组患者通气指标[第1秒用力呼气量(FEV1)、1秒用力呼吸容积与用力肺活量的比值(FEV1/FVC)],血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))],炎症因子[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-4和IL-23],排痰量、感染控制及住院时间。结果在肺通气功能指标方面,治疗后,两组FEV1、FEV1/FVC指标均增高,而试验组患者的FEV1、FEV1/FVC均高于对照组,差异有统计学意义(P<0.05);两组患者的SaO_(2)、PaO_(2)均较治疗前上升,试验组SaO_(2)、PaO_(2)显著高于对照组,PaCO_(2)水平均治疗前显著降低,试验组PaCO_(2)水平显著低于对照组,差异有统计学意义(P<0.05);两组患者的炎症因子hs-CRP、TNF-α、IL-4、IL-23均降低,试验组降低程度优于对照组,差异有统计学意义(P<0.05);试验组每日排痰量试验组多于对照组,感染控制时间和住院时间试验组短于对照组,差异有统计学意义(P<0.05)。结论支气管镜下肺泡灌洗可有效改善老年支气管扩张合并感染患者的肺功能和血气指标,抑制其机体内炎性反应。Objective To investigate the effect of bronchoscopic alveolar lavage on pulmonary function,blood gas indexes and inflammatory response in elderly patients with bronchiectasis and infection.Methods A total of 202 elderly patients with bronchiectasis and infection who were admitted to the Third People's Hospital of Kaifeng from February 2021 to February 2022 were selected as the research subjects.According to random number table,the patients were divided into experimental group and control group with 101 cases in each group.The control group underwent conventional conservative treatment,and the experimental group received bronchoscopic alveolar lavage on this basis.The ventilation index[forced expiratory volume at 1 second(FEV1),ratio of forced respiratory volume at 1 second to forced lung volume(FEV1/FVC)],blood gas index[arterial partial oxygen pressure(PaO_(2)),arterial carbon dioxide pressure(PaCO_(2)),arterial oxygen saturation(SaO_(2))],inflammatory factors[hypersensitivity-C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin(IL)-4,and IL-23]in both groups,sputum discharge,infection control,and hospital stay were recorded.Results In terms of pulmonary ventilation function indexes,FEV1 and FEV1/FVC of the two groups increased after treatment,while FEV1 and FEV1/FVC of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05);The SaO_(2) and PaO_(2) of the two groups were higher than those before treatment,the SaO_(2) and PaO_(2) of the experimental group were significantly higher than those of the control group,The PaCO_(2) of the two groups were lower than those before treatment,and the PaCO_(2) level of the experimental group was significantly lower than that of the control group before treatment,with statistically significant differences(P<0.05).The levels of hs-CRP,TNF-α,IL-4 and IL-23 in the two groups were decreased,and the degree of reduction in the experimental group was better than that in the control group,and the

关 键 词：支气管镜下肺泡灌洗 支气管扩张 肺功能 血气指标 炎症反应 

分 类 号：R562.22[医药卫生—呼吸系统]