支气管肺泡灌洗辅助治疗重症肺炎合并呼吸衰竭的临床效果研究  

The Efficacy and Safety of Bronchoalveolar Lavage in the Adjuvant Treatment of Severe Pneumonia Complicated with Respiratory Failure were Discussed

作　　者：孙恩强 田进 SUN Enqiang;TIAN Jin(Department of Critical Care Medicine,Sinan County People's Hospital,Sinan 565100,China)

机构地区：[1]思南县人民医院重症医学科,贵州思南565100

出　　处：《中华灾害救援医学》2025年第2期167-171,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨支气管肺泡灌洗辅助治疗重症肺炎合并呼吸衰竭的有效性及安全性。方法回顾性分析2023年1月至2024年1月思南县人民医院救治的88例重症肺炎合并呼吸衰竭患者为研究对象。根据是否联合支气管肺泡灌洗辅助治疗,分为观察组(44例)和对照组(44例)。比较两组研究对象的血气和炎症相关指标改善情况、临床症状转归时间、临床疗效及安全性。结果治疗前,两组患者血气相关指标:血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))和炎症相关指标:白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)水平均无明显差异(P>0.05)。治疗后,两组患者以上血气和炎症相关指标均明显改善(P<0.001)。与对照组相比,治疗后观察组患者PaO_(2)和SaO_(2)水平更高(P<0.001),PaCO_(2)、WBC、PCT、CRP水平更低(P<0.001)。与对照组相比,观察组患者体温恢复时间、肺部啰音消失时间、咳痰消失时间、咳嗽消失时间、抗菌药物使用时间以及住院时间明显更短(P<0.001)。观察组的临床有效率明显高于对照组(P<0.05)。观察组的不良反应总发生率与对照组相比无明显差异(P>0.05)。结论对于重症肺炎合并呼吸衰竭患者,支气管肺泡灌洗辅助治疗可有效改善患者血气相关指标,降低炎症指标水平,缩短临床症状消失时间,临床疗效明显,且不会增加不良反应发生率。Objective This study aims to investigate the efficacy and safety of bronchoalveolar lavage(BAL)as an adjunctive treatment for patients with severe pneumonia complicated by respiratory failure.Methods A retrospective analysis was conducted on 88 patients with severe pneumonia and respiratory failure treated at Sinan County People's Hospital from January 2023 to January 2024.Patients were divided into two groups based on whether they received adjunctive BAL therapy:the observation group(44 cases)and the control group(44 cases).The improvement in blood gas and inflammatory markers,the timeline for clinical symptom resolution,clinical efficacy,and safety were compared between the two groups.Results Prior to treatment,there were no significant differences in blood gas parameters,including partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),and blood oxygen saturation(SaO_(2)),as well as inflammatory markers such as white blood cell count(WBC),procalcitonin(PCT),and C-reactive protein(CRP)between the two groups(P>0.05).After treatment,all aforementioned blood gas and inflammatory parameters showed significant improvement in both groups(P<0.001).Compared to the control group,the observation group exhibited higher levels of PaO_(2)and SaO_(2)(P<0.001)and lower levels of PaCO_(2),WBC,PCT,and CRP(P<0.001)post-treatment.Additionally,the observation group had significantly shorter recovery times for fever resolution,disappearance of lung rales,cessation of sputum production,resolution of cough,duration of antibiotic therapy,and length of hospital stay compared to the control group(P<0.001).The clinical efficacy rate in the observation group was significantly higher than that in the control group(P<0.05).There were no significant differences in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion For patients with severe pneumonia complicated by respiratory failure,bronchoalveolar lavage as an adjunctive therapy can effectively improve blood gas parameters,reduce in

关 键 词：支气管肺泡灌洗 重症肺炎 呼吸衰竭 

分 类 号：R563.1[医药卫生—呼吸系统]