摘要
目的:探讨重症肺部感染并肺不张患者采用电子支气管镜进行支气管肺泡灌洗术(BAL)治疗的效果。方法:选取2013年1月~2018年3月我院收治的160例重症肺部感染并肺不张患者,根据患者是否采用电子支气管镜进行BAL治疗分为BAL组76例、非BAL组84例,两组均给予机械通气及抗感染治疗,BAL组同时采用电子支气管镜进行BAL治疗;对比两组患者治疗前后的动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、pH、血氧饱和度(SaO2)、血清降钙素原(PCT)、C反应蛋白(CRP)、血浆内脂素、肺顺应性、胸廓顺应性、总动态顺应性、肺部啰音消失时间、抗生素使用时间及机械通气治疗时间。结果:治疗前,两组患者的PaO2、PaCO2、pH、SaO2水平差异不具有统计学意义,治疗后,BAL组患者的PaO2、pH、SaO2水平均高于非BAL组,PaCO2水平均低于非BAL组;治疗前,两组患者的PCT、CRP、血浆内脂素水平差异不具有统计学意义,治疗后,BAL组患者的PCT、CRP、血浆内脂素水平均低于非BAL组;治疗前,两组患者的肺顺应性、胸廓顺应性、总动态顺应性差异不具有统计学意义,治疗后,BAL组患者的肺顺应性、胸廓顺应性、总动态顺应性均高于非BAL组;治疗后,BAL组患者的肺部啰音消失时间、抗生素使用时间及机械通气治疗时间均低于非BAL组。结论:重症肺部感染并肺不张患者采用BAL治疗有助于患者感染病情的控制、及时改善患者的血气、炎症反应及呼吸功能。
Objective To investigate the effect of bronchoalveolar lavage(BAL)in patients with severe pulmonary infection and atelectasis using electronic bronchoscopy.Methods From January 2013 to March 2018,160 patients with severe pulmonary infection and atelectasis admitted to our hospital were divided into BAL group(76 cases)and non-BAL group(84 cases)according to whether patients were treated with electronic bronchoscopy for BAL.The patients were given mechanical ventilation and anti-infective treatment.The BAL group was treated with electronic bronchoscopy for BAL.The arterial oxygen partial pressure(PaO2),arterial blood carbon dioxide partial pressure(PaCO2),pH,blood oxygen before and after treatment were compared between the two groups.Saturation(SaO2),serum procalcitonin(PCT),C-reactive protein(CRP),plasma visfatin,lung compliance,thoracic compliance,total dynamic compliance,lung murmur disappearance time,antibiotic use time And mechanical ventilation treatment time.Results Before treatment,the levels of PaO2,PaCO2,pH and SaO2 in the two groups were not statistically significant.After treatment,the PaO2,pH and SaO2 levels in the BAL group were higher than those in the non-BAL group.PaCO2 level was lower than that of non-BAL group.There was no significant difference in PCT,CRP and plasma visfatin levels between the two groups before treatment.After treatment,patients in BAL group The PCT,CRP,and plasma visfatin levels were lower than those in the non-BAL group.There was no significant difference in lung compliance,thoracic compliance,and total dynamic compliance between the two groups before treatment,after treatment,the lung compliance,thoracic compliance,and total dynamic compliance of the BAL group were higher than those of the non-BAL group.After treatment,the lungs of the BAL group disappeared,antibiotics were used.Time and mechanical ventilation treatment time were lower than non-BAL group.Conclusion BAL treatment in patients with severe pulmonary infection and atelectasis can help the patient’s infection con
作者
徐光辉
王庆东
张梁
Xu Guang-hui;Wang Qing-dong;Zhang Liang(Respiratory Department,Funing County People’s Hospital,Funing 224400,China)
出处
《湖南师范大学学报（医学版）》
2020年第3期179-182,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
重症肺部感染
肺不张
电子支气管镜
支气管肺泡灌洗术
severe pulmonary infection
atelectasis
electronic bronchoscopy
bronchoalveolar lavage
