纤维支气管镜吸痰灌洗配合血必净治疗重症肺炎合并呼吸衰竭患者的效果  

Effect of Bronchofiberscope Sputum Aspiration and Lavage Combined with Xuebijing in the Treatment of Patients with Severe Pneumonia Complicated with Respiratory Failure

作　　者：朱军红 ZHU Junhong(Baoying Eryuan Hospital,Baoying 225800,China)

机构地区：[1]宝应二圆医院,江苏宝应225800

出　　处：《中外医学研究》2024年第34期115-119,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究纤维支气管镜吸痰灌洗配合血必净治疗重症肺炎(severe pneumonia,SP)合并呼吸衰竭(respiratory failure,RF)患者的效果。方法:选择2021年1月—2023年12月在宝应二圆医院接受治疗的65例SP合并RF患者作为研究对象,采用电脑随机排列法将患者分为配合组(n=32)和对照组(n=33)。对照组采用纤维支气管镜吸痰灌洗治疗,配合组在对照组基础上增用血必净治疗。比较两组治疗效果、康复指标、肺功能指标、血清分化簇40配体(differentiated cluster 40 ligand,CD40L)、诱骗受体3(decoy receptor 3,DcR3)水平。结果:配合组总有效率高于对照组,咳嗽与肺部啰音消失时间、机械通气时间及重症监护室(intensive care unit,ICU)治疗时间均短于对照组,差异有统计学意义(P<0.05);治疗2周后,两组第1秒用力呼气容积(forced expiratory volume for one second,FEV_(1))、FEV_(1)/用力肺活量(forced vital capacity,FVC)及呼气峰流速(peak expiratory flow,PEF)高于治疗前,且配合组高于对照组,差异有统计学意义(P<0.05);治疗2周后,两组血清CD40L、DcR3水平均低于治疗前,且配合组低于对照组,差异有统计学意义(P<0.05)。结论:纤维支气管镜吸痰灌洗配合血必净治疗SP合并RF患者的效果较佳,可促进患者肺功能康复,降低血清CD40L、DcR3水平。Objective:To investigate the effect of bronchofiberscope sputum aspiration and lavage combined with Xuebijing in the treatment of patients with severe pneumonia(SP)complicated with respiratory failure(RF).Method:A total of 65 patients with SP complicated with RF who treated in Baoying Eryuan Hospital from January 2021 to December 2023 were selected as the research objects,the patients were divided into the cooperation group(n=32)and the control group(n=33)by computer random arrangement method.The control group was treated with bronchofiberscope sputum aspiration and lavage,and the cooperation group was treated with additional Xuebijing on the basis of the control group.The therapeutic effect,rehabilitation indexes,pulmonary function indexes,serum differentiated cluster 40 ligand(CD40L)and decoy receptor 3(DcR3)levels were compared between two groups.Result:The total effective rate of the cooperation group was higher than that of the control group,and the disappearance time of cough and pulmonary rales,mechanical ventilation time and intensive care unit(ICU)treatment time were shorter than those of the control group,the differences were statistically significant(P<0.05);after 2 weeks of treatment,the forced expiratory volume for one second(FEV_(1)),FEV_(1)/forced vital capacity(FVC)and peak expiratory flow(PEF)in two groups were higher than those before treatment,and those in the cooperation group were higher than those in the control group,the differences were statistically significant(P<0.05);after 2 weeks of treatment,the levels of serum CD40 L and DcR3 in two groups were lower than those before treatment,and those in the cooperation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Bronchofiberscope sputum aspiration and lavage combined with Xuebijing in the treatment of patients with SP complicated with RF is effective,and which can promote the rehabilitation of lung function and reduce the levels of serum CD40 L and DcR3.

关 键 词：重症肺炎 呼吸衰竭 纤维支气管镜吸痰灌洗 血必净 分化簇40配体 诱骗受体3 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]