摘要
目的:探讨联用纤维支气管镜肺泡灌洗术(BAL)及无创通气在重症肺炎(SP)合并呼吸衰竭中的临床效果。方法:选取78例泉州市第一医院2020年1月-2022年1月收治的SP合并呼吸衰竭患者,按随机数字表法分为两组,各39例。两组均采用基础治疗,对照组予以无创通气治疗,在此基础上,观察组加用BAL治疗。两组均于治疗7 d后评价临床疗效、血气分析指标、炎症因子水平及全身炎症反应综合征(SIRS)发生率。结果:观察组总有效率[94.87%(37/39)]高于对照组[79.49%(31/39)],治疗后动脉血氧分压(PaO_(2))[(90.42±6.52)mmHg]、血氧饱和度(SaO_(2))[(93.25±2.38)%]均高于对照组[(83.57±6.45)mm Hg、(90.14±2.33)%],二氧化碳分压(PaCO_(2))[(38.96±3.25)mm Hg]低于对照组[(43.87±3.86)mmHg],差异均有统计学意义(P<0.05);观察组治疗后C反应蛋白(CRP)水平[(9.52±1.29)mg/L]、肿瘤坏死因子-α(TNF-α)水平[(138.52±10.49)ng/mL]及白介素-6(IL-6)水平[(35.26±3.28)pg/mL]均低于对照组[(12.24±1.43)mg/L、(150.36±12.47)ng/mL、(42.71±4.15)pg/mL],差异均有统计学意义(P<0.05);观察组SIRS发生率较对照组低,差异有统计学意义(P<0.05)。结论:联用BAL及无创通气可提高SP合并呼吸衰竭的治疗效果,减轻肺部炎症反应,纠正血气分析异常,降低SIRS发生风险。
Objective:To investigate the clinical effect of bronchofibroscopic alveolar lavage(BAL)combined with non-invasive ventilation in the treatment of severe pneumonia(SP)with respiratory failure.Method:A total of 78 patients with SP combined with respiratory failure admitted to Quanzhou First Hospital from January 2020 to January 2022 were randomly divided into two groups,39 patients in each group.Both groups were given routine treatment,the control group was given non-invasive ventilation treatment,and on this basis,the observation group was given BAL treatment.The clinical efficacy,blood gas analysis index,inflammatory factor level,pulmonary function index and incidence of systemic inflammatory response syndrome(SIRS)were evaluated in both groups 7 days after treatment.Result:The total effective rate of the observation group[94.87%(37/39)]was higher than that[79.49%(31/39)]of the control group(P<0.05).After treatment,PaO_(2)[(90.42±6.52)mmHg]and SaO_(2)[(93.25±2.38)%]in the observation group were higher than those[(83.57±6.45)mmHg,(90.14±2.33)%]in the control group,while PaCO_(2)[(38.96±3.25)mmHg]in the observation group was lower than that[(43.87±3.86)mmHg]in the control group(P<0.05).The levels of C reactive protein(CRP)[(9.52±1.29)mg/L],tumor necrosis factor-α(TNF-α)[(138.52±10.49)ng/mL]and interleukin-6(IL-6)[(35.26±3.28)pg/mL]in the observation group after treatment were lower than those[(12.24±1.43)mg/L,(150.36±12.47)ng/mL,(42.71±4.15)pg/mL]in the control group(P<0.05).The incidence of SIRS in the observation group was lower than that in the control group,with statistical difference(P<0.05).Conclusion:Combined use of BAL and non-invasive ventilation can improve the therapeutic effect of SP with respiratory failure,reduce pulmonary inflammatory reaction,correct abnormal blood gas analysis,and reduce the risk of SIRS.
作者
杨娟
YANG Juan(Quanzhou First Hospital,Fujian Province,Quanzhou 362000,China)
出处
《中国医学创新》
CAS
2023年第11期27-30,共4页
Medical Innovation of China
关键词
重症肺炎
呼吸衰竭
纤维支气管镜肺泡灌洗
无创通气
血气分析
Severe pneumonia
Respiratory failure
Bronchofiberscope alveolar lavage
Non-invasive ventilation
Blood gas analysis
