摘要
目的探讨纤维支气管镜吸痰及肺泡灌洗在长期卧床老年社区获得性肺炎(CAP)患者中的临床价值。方法选取2017年1月~2019年12月就诊本院的长期卧床老年CAP患者84例,按照随机数字表法分为试验组和对照组,每组42例,两组均给予常规经验性抗感染治疗,并给予翻身拍背和雾化化痰治疗;试验组同时给予纤维支气管镜吸痰及肺泡灌洗。分析两组患者治疗前与治疗72h后白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)及血气分析;比较两组患者的治疗有效率。结果两组治疗72h后WBC、CRP、PCT水平显著降低,血氧分压(PaO2)及血氧饱和度(SpO2)显著升高,试验组改善情况优于对照组,差异有统计学意义(P<0.05),但两组治疗前上述指标差异无统计学意义(P>0.05);试验组总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论针对长期卧床老年CAP患者行纤维支气管镜治疗,能快速缓解炎症反应,改善氧合功能,提高疗效。
Objective To explore the clinical value of sputum suction by fibrobronchoscope and bronchoalveolar lavage in long-term bedridden elderly patients with community acquired pneumonia(CAP).Methods 84 longterm bedridden elderly patients with CAP who were treated in our hospital from January 2017 to December 2019 were selected and divided into the experimental group and the control group according to random number table,with 42 patients in each group.Both groups were given conventional empirical anti-infection therapy,and were also given turning-over and back patting and atomization expectorant therapy.Meanwhile,the experimental group was given sputum suction by fibrobronchoscope and bronchoalveolar lavage.White blood cell(WBC)count,C-reactive protein(CRP),procalcitonin(PCT)and blood gas analysis of the two groups before and 72 h after treatment were analyzed.The effective rate of treatment was compared between the two groups.Results After 72 h of treatment,the WBC,CRP and PCT levels in the two groups decreased significantly,while the partial pressure of blood oxygen(PaO2)and oxygen saturation(SpO2)levels increased significantly,and the improvement in the experimental group was superior to that in the control group,with statistically significant difference(P<0.05),but there was no statistically significant difference in the above indexes between the two groups before treatment(P>0.05).The total effective rate in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Fibrobronchoscopy for long-term bedridden elderly patients with CAP can rapidly relieve the inflammatory reaction,ameliorate the oxygenation function and improve the curative effect.
作者
陈坤
CHEN Kun(Department of Respiratory Medicine,Nanping First Hospital Affiliated to Fujian Medical University,Fujian,Nanping 353000,China)
出处
《中国医药科学》
2020年第16期206-209,共4页
China Medicine And Pharmacy
关键词
长期卧床
老年患者
社区获得性肺炎
纤维支气管镜吸痰
肺泡灌洗
Long-term bedridden
Elderly patients
Community acquired pneumonia
Sputum suction by fibrobronch oscope
Bronchoalveolar lavage
