支气管肺泡灌洗联合比阿培南降阶梯疗法对慢性阻塞性肺疾病伴重症肺炎患者炎症因子及肺功能的影响  

Effect of Bronchoalveolar Lavage Combined with Biapenem De-escalation Therapy on Inflammatory Factors and Lung Function in Patients with Chronic Obstructive Pulmonary Disease Complicated with Severe Pneumonia

作　　者：武光瑞 黄海臣 WU Guang-rui;HUANG Hai-chen(Department of Respiratory and Critical Care Medicine,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院呼吸与危重症医学科,信阳464000

出　　处：《中国合理用药探索》2024年第6期50-56,共7页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨支气管肺泡灌洗联合比阿培南降阶梯疗法对慢性阻塞性肺疾病(COPD)伴重症肺炎患者的治疗效果。方法:选取2020年2月~2023年2月期间某院收治的80例COPD伴重症肺炎患者作为研究对象,采用随机数字表法分为对照组和观察组,每组40例。对照组患者给予比阿培南降阶梯疗法治疗,观察组患者在对照组治疗基础上给予支气管肺泡灌洗。比较两组患者血气分析指标[血氧饱和度(SO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)]、肺功能指标[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)]、临床疗效及不良反应发生情况。结果:治疗后,两组患者SO_(2)、PaO_(2)均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者PaCO_(2)均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者WBC、CRP、IL-6、PCT均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者FEV_(1)、PEF、FEV_(1)/FVC均升高(P<0.05),且观察组高于对照组(P<0.05)。观察组患者治疗总有效率(95.00%)高于对照组(77.50%,P<0.05);两组患者不良反应发生率比较无统计学差异(P>0.05)。结论:支气管肺泡灌洗联合比阿培南降阶梯疗法治疗COPD伴重症肺炎患者临床疗效确切,可有效改善患者肺功能,减轻炎症反应,且未增加不良反应的发生风险。Objective:To investigate the effect of bronchoalveolar lavage combined with biapenem deescalation therapy on chronic obstructive pulmonary disease(COPD)patients with severe pneumonia.Methods:A total of 80 COPD patients with severe pneumonia treated in a central hospital from February 2020 to February 2023 were selected and assigned to the control group and observation group by random number table method,with 40 patients in each group.The control group was treated with biapenem deescalation therapy,and the observation group was treated with bronchoalveolar lavage in addition to the control treatment.The blood gas analysis indexes[blood oxygen saturation(SO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],inflammatory indexes[white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)],pulmonary function indexes[forced expiratory volume in one second(FEV_(1)),peak expiratory flow(PEF),forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC)],clinical efficacy and adverse reactions were compared between the two groups.Results:After treatment,the levels of SO_(2) and PaO_(2) were higher in both groups(P<0.05),and were higher in the observation group than those in the control group(P<0.05).PaCO_(2) was decreased in both groups(P<0.05),and was lower in the observation group than that in the control group(P<0.05).WBC,CRP,IL-6 and PCT were decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).FEV_(1),PEF and FEV_(1)/FVC were increased in both groups(P<0.05),and were higher in the observation group than those in the control group(P<0.05).The total effective rate of the observation group(95.00%)was higher than that of the control group(77.50%,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Bronchoalveolar lavage combined with biapenem de-escalation therapy in the treatment of COPD patient

关 键 词：比阿培南 降阶梯疗法 慢性阻塞性肺疾病 重症肺炎 支气管肺泡灌洗 炎症反应 

分 类 号：R563.9[医药卫生—呼吸系统]