肺泡灌洗对急诊重症肺炎伴呼吸衰竭患者血清炎症指标及预后结局的影响  

Effects of alveolar lavage on serum inflammatory indexes and prognosis in patients with severe pneumonia complicated with respiratory failure in emergency department

作　　者：李雪娇 申艳茹 李保军[1] LI Xuejiao;SHEN Yanru;LI Baojun(Emergency Department,Anyang District Hospital,Anyang 455000,China)

机构地区：[1]濮阳市安阳地区医院急诊科,河南安阳455000

出　　处：《临床医学研究与实践》2025年第5期53-56,共4页Clinical Research and Practice

摘　　要：目的研究肺泡灌洗对急诊重症肺炎伴呼吸衰竭患者血清炎症指标以及预后结局的影响。方法选取2018年10月至2022年11月我院收治的80例急诊重症肺炎伴呼吸衰竭患者,按随机数字表法将其分为对照组(n=40)和观察组(n=40)。对照组采用常规治疗,观察组在此基础上联合肺泡灌洗治疗。比较两组的临床疗效、血气指标、血清炎症指标、病情程度。结果观察组的治疗总有效率为95.00%,高于对照组的80.00%(P<0.05)。治疗后,观察组的动脉血氧分压(PaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。治疗后,观察组的C反应蛋白(CRP)、降钙素原(PCT)及可溶性髓系细胞触发受体-1(sTREM-1)水平低于对照组(P<0.05)。治疗后,观察组的临床肺部感染评分(CPIS)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分显著低于对照组(P<0.05)。结论肺泡灌洗对急诊重症肺炎伴呼吸衰竭患者疗效确切,可改善呼吸困难症状及血气指标,减轻炎症反应,预后良好。Objective To study the effects of alveolar lavage on serum inflammatory indexes and prognosis in patients with severe pneumonia and respiratory failure in emergency department.Methods A total of 80 patients with severe pneumonia and respiratory failure in emergency department admitted in our hospital from October 2018 to November 2022 were selected and divided into control group(n=40)and observation group(n=40)according to random number table method.The control group was given conventional therapy,and the observation group was treated with alveolar lavage on this basis.The clinical efficacy,blood gas indexes,serum inflammatory indexes and disease degree of the two groups were compared.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than 80.00%in the control group(P<0.05).After treatment,the arterial partial pressure of oxygen(PaO_(2))in the observation group was higher than that in the control group,and the arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that in the control group(P<0.05).After treatment,the levels of C-reactive protein(CRP),procalcitonin(PCT)and soluble myeloid cells trigger receptor-1(sTREM-1)in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of Clinical Pulmonary Infection Score(CPIS)and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Alveolar lavage has a definite effect on patients with severe pneumonia and respiratory failure in emergency department.It can improve dyspnea symptoms and blood gas indexes,and reduce inflammatory response,with good prognosis.

关 键 词：肺泡灌洗 重症肺炎 呼吸衰竭 炎症指标 预后 

分 类 号：R563.1[医药卫生—呼吸系统]