摘要
目的研究纤维支气管镜下肺泡灌洗对支气管扩张合并感染患者血气指标及血清TNF-α、hs-CRP、IL-4水平的影响。方法回顾性分析该院2017年2月—2020年8月收治的支气管扩张合并感染患者中的241例,按照治疗的方法不同分为对照组(n=120)和治疗组(n=121)。对照组患者服用哌拉西林钠舒巴坦钠治疗,治疗组患者在前者基础上合用纤维支气管镜下肺泡灌洗治疗,1周为1个疗程,两组均治疗2个疗程。比较治疗后两组患者临床疗效,治疗前后血气指标PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)及血清TNF-α、hs-CRP、IL-4水平的变化。结果治疗组患者的临床有效率为98.34%比对照组的75.83%高,差异有统计学意义(χ^(2)=27.246,P<0.05);治疗后两组患者PaO_(2)及PaO_(2)/FiO_(2)水平较治疗前均升高,且治疗组较对照组高,PaCO_(2)及血清TNF-α、hs-CRP、IL-4水平均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜下肺泡灌洗可有效缓解患者临床症状,提高患者临床疗效,改善患者血气指标水平,保护患者呼吸功能,减轻患者炎症反应。
Objective To study the effect of alveolar lavage under fiberoptic bronchoscopy on blood gas index and serum TNF-α,hs-CRP,IL-4 level in patients with bronchiectasis complicated with infection.Methods A retrospective analysis of 241 patients with bronchiectasis and infections admitted to the hospital from February 2017 to August 2020 were divided into control group(n=120)and treatment group(n=121)according to different treatment methods.Patients in the control group were treated with piperacillin sodium and sulbactam sodium,and patients in the treatment group were treated with fiberoptic bronchoscopic alveolar lavage on the former.1 week was a course of treatment,and both groups were treated for 2 courses.The clinical efficacy of the two groups of patients after treatment were compared,and the changes of blood gas indexes PaO_(2),PaCO_(2),PaO_(2)/FiO_(2) and serum TNF-α,hs-CRP and IL-4 levels before and after treatment were compared.Results The clinical effective rate of patients in the treatment group was 98.34%higher than 75.83%in the control group,and the difference was statistically significant(χ^(2)=27.246,P<0.05);after treatment,the levels of PaO_(2) and PaO_(2)/FiO_(2) in both groups were higher than before treatment and the treatment group was higher than the control group,PaCO_(2) and serum TNF-α,hs-CRP,IL-4 levels were lower,and the treatment group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Fiberoptic bronchoscope alveolar lavage can effectively relieve the clinical symptoms of patients,improve the clinical efficacy of patients and blood gas levels,and to protect respiratory function,reduce the inflammatory response in patients.
作者
冯家华
FENG Jiahua(Department of Respiratory and Critical Care,Dongguan Binhaiwan Central Hospital,Dongguan,Guangdong Province,523900China)
出处
《系统医学》
2021年第18期100-103,共4页
Systems Medicine
