乙酰半胱氨酸联合支气管肺泡灌洗治疗支气管扩张并感染的临床疗效  

Clinical effect of acetyl cysteine combined with bronchoalveolar lavage in the treatment of bronchiectasis and infection

作　　者：李艳玲 沈俊芳 李芳 张静 苏建林 LI Yanling;SHEN Junfang;LI Fang;ZHANG Jing;SU Jianlin(Department of Respiratory and Critical Care Medicine,Chenggong District People's Hospital,Kunming,Yunnan,650599,China)

机构地区：[1]呈贡区人民医院呼吸与危重症医学科,云南昆明650599

出　　处：《当代医学》2024年第18期6-10,共5页Contemporary Medicine

基　　金：昆明市卫生健康委员会卫生科研课题项目(2022-03-02-014)。

摘　　要：目的探讨乙酰半胱氨酸联合支气管肺泡灌洗(bronchoalveolar lavage,BAL)治疗支气管扩张(bronchiectasis,BE)合并感染的效果。方法选取2021年1月至2022年9月呈贡区人民医院收治的32例BE合并感染患者作为研究对象,采用随机数字表法分为观察组与对照组,每组16例。观察组采用乙酰半胱氨酸联合BAL治疗,对照组采用常规治疗。比较两组临床疗效,治疗前后动脉血氧分压(partial pressure of arterial oxygen,PaO_(2))、动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood,PaCO_(2))、动脉血氧饱和度(arterial oxygen saturation,SaO_(2))、C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、血清淀粉样蛋白A(serum amyloid A,SAA)、肺功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、第1秒用力呼气容积占用力肺活量比值(FEV_(1)/FVC)]及日常生活能力量表评分。结果两组治疗总有效率比较差异无统计学意义。治疗后,观察组PaO_(2)、SaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组PCT、CRP、SAA水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组FEV_(1)、FVC均大于对照组,FEV_(1)/FVC高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组总体健康、躯体疼痛、活力、社会功能、情感职能、精神健康、生理功能、生理职能评分均高于对照组,差异有统计学意义(P<0.05)。结论乙酰半胱氨酸联合BAL治疗BE合并感染疗效显著,可减轻患者炎症反应,改善肺功能与肺血气指标,促进身体康复,值得临床推广应用。Objective To explore the effects of acetylcysteine combined with bronchoalveolar lavage(BAL)in the treatment of patients with bronchiectasis(BE)and infection.Methods A total of 32 patients with bronchiectasis and infection admitted to Chenggong District People's Hospital from January 2021 to September 2022 were selected as the study subjects,and they were divided into the observation group and the control group according to the random number table methods,with 16 cases in each group.The observation group received acetylcysteine combined with BAL treatment,while the control group received conventional therapy.The clinical efficacy,the partial pressure of arterial oxygen(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),arterial oxygen saturation(SaO_(2)),C-reactive protein(CRP),procalcitonin(PCT),serum amyloid A(SAA),pulmonary function(forced vital capacity[FVC],forced expiratory volume in one second[FEV_(1)],and FEV_(1)/FVC ratio),and activity of daily living scores before and after treatment were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups.After treatment,the PaO_(2)and SaO_(2)in the observation group were higher than those in the control group,and PaCO_(2)was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of PCT,CRP and SAA in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,FEV_(1) and FVC in the observation group were larger than those in the control group,and FEV_(1)/FVC was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the overall health,physical pain,vitality,social function,emotional function,mental health,physiological function and physiological function scores in the observation group were higher than those in the control group,and the differences were statistically sign

关 键 词：支气管扩张 乙酰半胱氨酸 支气管肺泡灌洗 

分 类 号：R562.2[医药卫生—呼吸系统]