摘要
目的:探究纤维支气管镜肺泡灌洗治疗重症肺炎的临床疗效。方法:①随机选取2018年1月~2020年1月于都江堰市第二人民医院诊治的60例重症肺炎患者,由SAS软件生成随机数字表,按入院时间先后随机分为三组,即对照组,低频率治疗组和高频率治疗组,每组各20例。对照组予以西医常规治疗;低频率治疗组在对照组治疗基础上予以纤维支气管镜行肺泡灌洗治疗,1次/每3天;高频率治疗组在对照组治疗基础上予以纤维支气管镜行肺泡灌洗治疗,1次/d,各组均连续治疗8 d;②治疗前后记录各组患者临床症状、体征,并完善相关生化和胸部CT检查,比较各组患者治疗前后临床肺部感染评分、APACHEⅡ评分、肺活量变化情况;③治疗前后检测并比较各组患者外周血中IL-6和TNF-α水平以及各组不良反应发生情况。结果:①对照组、低频率治疗组和高频率治疗组这三组患者试验前后的CPIS评分、APACHEⅡ评分和FEV1/FVC比值比较,差异均具有统计学意义(P<0.05),CPIS评分和APACHEⅡ评分较前减低,FEV1/FVC比值较前升高,差异有统计学意义(P<0.05)。且试验后治疗组的CPIS评分和APACHEⅡ评分均低于对照组,而治疗组的FEV1/FVC比值高于对照组,但低频率治疗组和高频率治疗组的CPIS评分、APACHEⅡ评分和FEV1/FVC比值比较差异无统计学意义(P>0.05)。②试验后三组患者的血IL-6和TNF-α水平比较,差异均具有统计学意义(P<0.01),且对照组的血IL-6和TNF-α水平较试验前升高,而低频率治疗组和高频率治疗组的血IL-6和TNF-α水平较试验前降低,差异有统计学意义(P<0.01)。但低频率治疗组和高频率治疗组血IL-6和TNF-α水平的组间比较,差异并无统计学意义(P>0.05)。③整个试验期间,对照组和低频率治疗组均无特殊不良反应,而高频率治疗组患者治疗期间5例发生心律失常,经对症处理后好转并继续试验。结论:肺泡灌洗治疗重症肺炎疗效确�
Objective To investigate the clinical efficacy of bronchoscope alveolar lavage in the treatment of severe pneumonia.Method①60 cases of severe pneumonia patients treated in dujiangyan second people's hospital from January 2018 to January 2020 were randomly selected.The SAS software generated a random number table and randomly divided into three groups according to the admission time sequence,namely the control group,the low-frequency treatment group and the high-frequency treatment group,with 20 patients in each group.The control group received conventional treatment in western medicine,the low-frequency group received alveolar lavage treatment with bronchoscopy on the basis of treatment in the control group,once every 3 days,and the high-frequency group received alveolar lavage treatment with bronchoscopy on the basis of treatment in the control group,once per day,each group received continuous treatment for 8 days.②Record groups of patients before and after the treatment of clinical symptoms,signs,biochemical and chest CT examination,and perfect the relevant comparison between groups before and after treatment in patients with clinical pulmonary infection score,APACHEⅡscore,vital capacity changes;③Peripheral blood levels of IL-6 and TNF-αand the occurrence of adverse reactions in each group were detected and compared before and after treatment.Results①The treatment group and control group,low frequency and high frequency in treatment group the CPIS score of three groups of patients before and after the test,the APACHEⅡscore and FEV1/FVC of comparison,the differences were statistically significant(P<0.05),the CPIS score and APACHEⅡscore decreased from the previous,higher FEV1/FVC ratio from the previous(P<0.05).And after test CPIS score and APACHEⅡscore in treatment group were lower than the control group,the treatment group(FEV1/FVC ratio higher than the control,but the group treated with low frequency and high frequency treatment group CPIS score and APACHEⅡscore and FEV1/FVC ratio comparison
作者
曾鸣鸣
ZENG Ming-ming(Respiratory department,The Second People's Hospital of Dujiangyan City,Chengdu 611830,China)
出处
《吉林医学》
CAS
2021年第3期572-575,共4页
Jilin Medical Journal
关键词
重症肺炎
肺泡灌洗
临床疗效
Severe pneumonia
Alveolar lavage
Clinical curative effect
