摘要
目的分析纤维支气管镜肺泡灌洗(BAL)辅助常规治疗对重症肺炎患者的效果及对呼吸力学指标的影响。方法抽取解放军联勤保障部队第九八九医院2018年6月至2021年8月收治的重症肺炎患者62例,按随机数字表法分为BAL组和常规组,每组31例。常规组予以常规治疗,BAL组在常规组的基础上予以BAL治疗。比较两组病情转归进程、不良反应及治疗前后肺功能、呼吸力学指标及炎性因子变化情况。结果BAL组咳嗽、咳痰消失时间,湿啰音消失时间,发热消失时间,肺部阴影吸收时间均短于常规组(P均<0.05);治疗后,BAL组用力肺活量、第1秒用力呼气容积大于常规组(P<0.05);治疗后,BAL组气道阻力、气道峰压低于常规组(P<0.05);治疗后,BAL组白细胞介素-4、C反应蛋白水平低于常规组(P<0.05);BAL组不良反应发生率(3.23%,1/31)与常规组(9.68%,3/31)比较差异未见统计学意义(P>0.05)。结论BAL辅助常规治疗重症肺炎患者,可促进病情转归和炎性物质吸收,减少对肺功能与呼吸力学的影响,且安全性良好。
Objective To analyze the effect of fiberoptic bronchoscopic alveolar lavage(BAL)assisted routine treatment on severe pneumonia,and the influence on respiratory mechanical indexes.Methods Sixty-two patients with severe pneumonia treated in No.989 Hospital of the Joint Logistic Support Force from June 2018 to August 2021 were selected and divided into BAL group and conventional group by random number table method,with 31 patients in each group.The conventional group was treated by conventional treatment,and the BAL group was treated by BAL based on the treatment of the conventional group.The progress of disease outcome,adverse reactions,pulmonary function,respiratory mechanics indexes and inflammatory factors before and after treatment were compared between the two groups.Results Compared with conventional group,BAL group had shorter disappearance time of sputum,moist rales,fever and lung shadow absorption(all P<0.05).After treatment,forced vital capacity and forced expiratory volume in 1 second in the BAL group were higher than those in the conventional group(P<0.05).After treatment,the airway resistance and peak airway pressure in the BAL group were lower than those in the conventional group(P<0.05).After treatment,interleukin-4 and C-reactive protein levels in the BAL group were lower than those in the conventional group(P<0.05).There was no significant difference in incidence of adverse reactions between the BAL group(3.23%,1/31)and the conventional group(9.68%,3/31),P>0.05.Conclusions BAL assisted routine treatment for severe pneumonia patients can promote the outcome of the disease,promote the absorption of inflammatory substances,and reduce the impact of lung function and respiratory mechanics,with good safety.
作者
崔燕
董斌
毛小辉
Cui Yan;Dong Bin;Mao Xiaohui(Department of Respiratory and Critical Care Medicine,No.989 Hospital of the Joint Logistic Support Force,Pingdingshan 467000,China)
出处
《中国实用医刊》
2022年第15期52-55,共4页
Chinese Journal of Practical Medicine
关键词
肺炎
重症
纤维支气管镜肺泡灌洗
常规治疗
呼吸力学指标
Pneumonia
Severe
Fiberoptic bronchoscopic alveolar lavage
Routine treatment
Respiratory mechanical index
