摘要
目的探讨支气管肺泡灌洗术(BAL)联合机械通气治疗重症肺部感染的临床效果。方法抽取2017年1月至2020年10月阳泉煤业(集团)有限责任公司总医院收治的重症肺部感染患者120例,采用随机数字表法分为观察组和对照组,每组60例。对照组实施抗感染、盐酸氨溴索、机械通气治疗,观察组在对照组治疗方案的基础上实施BAL。比较两组总有效率、机械通气时间、住院时长、血清炎性因子、肺通气功能及动脉血气状况。结果观察组总有效率(96.67%,58/60)高于对照组(85.00%,51/60),P<0.05。观察组机械通气时间、住院时间均短于对照组(P均<0.05)。治疗后,两组血清CRP、PCT水平均低于治疗前(P均<0.05),且观察组低于对照组(P<0.05)。治疗后,两组1 s用力呼吸容积、1 s用力呼吸容积与肺活量比值均高于治疗前(P均<0.05),且观察组高于对照组(P<0.05)。治疗后,两组动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))均较治疗前改善(P均<0.05)。治疗后,观察组PaO_(2)、SpO_(2)均高于对照组(P均<0.05),PaCO_(2)低于对照组(P<0.05)。结论在重症肺部感染患者机械通气治疗期间实施BAL,可有效缩短机械通气时间和住院时间,减轻炎症反应,改善肺通气功能和动脉血气状况,获得良好的临床疗效。
Objective To investigate the clinical effect of bronchoalveolar lavage(BAL)combined with mechanical ventilation on severe pulmonary infection.Methods A total of 120 patients with severe pulmonary infection treated in Yangquan Coal Industry(Group)General Hospital from January 2017 to October 2020 were selected and divided into control group and observation group by the random number table method,with 60 cases in each group.The control group was treated by anti-infection,ambroxol hydrochloride and mechanical ventilation.The observation group was treated by BAL based on the treatment of the control group.The total effective rate,mechanical ventilation time,hospitalization time,serum inflammatory factor index,pulmonary ventilation function index,and arterial blood gas status of the two groups were compared.Results The total effective rate of observation group(96.67%,58/60)was higher than that of control group(85.00%,51/60),P<0.05.The duration of mechanical ventilation and hospital stay in the observation group were shorter than those in the control group(all P<0.05).After treatment,the levels of serum C-reactive protein and procalcitonin in both groups were lower than before treatment(all P<0.05),while the postoperative levels of serum CRP and PCT in observation group were lower than those in control group(P<0.05).After treatment,forced expiratory volume in one second(FEV1),and forced expiratory volume in one second/forced vital capacity(FEV1/FVC)in both groups were higher than those before treatment(P<0.05);while FEV1,FEV1/FVC in observation group were higher than those in control group after treatment(P<0.05).After treatment,the arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and oxygen saturation(SpO_(2))of the two groups were significantly improved(P<0.05).The postoperative PaO_(2) and SpO_(2) in observation group were higher than those in control group(P<0.05),while postoperative PaCO_(2) in observation group was lower than that in control group(P<0.05).Conclusio
作者
李志明
Li Zhiming(Department of Respiratory and Critical Care Medicine,Yangquan Coal Industry(Group)General Hospital,Yangquan 045000,China)
出处
《中国实用医刊》
2021年第15期66-69,共4页
Chinese Journal of Practical Medicine
关键词
支气管肺泡灌洗术
呼吸内科
肺部感染
机械通气
Bronchoalveolar lavage
Respiratory medicine department
Pulmonary infection
Mechanical ventilation
