摘要
目的探讨纤支镜肺泡灌洗结合振动排痰在肺炎患儿中的应用效果。方法选取2019年4月-2022年7月52例重症肺炎患儿,通过随机数字表法分为观察组与对照组,每组各26例,对照组行纤维支气管镜肺泡灌洗术(BAL)治疗,观察组给予BAL结合振动排痰治疗,在灌洗前,给予高频振动排痰,持续治疗7 d,比较两组临床疗效、临床恢复、呼吸功能、血气指标、炎性指标水平以及不良反应发生情况。结果观察组每日排痰量大于对照组,机械通气时间、住ICU时间短于对照组(P<0.05);观察组治疗后呼吸功能指标气道峰值吸气压力(PIP)、气道阻力(RAW)、呼吸做功(WOB)水平低于对照组,动态肺顺应性(CLdyn)水平高于对照组(P<0.05);观察组治疗后动脉血氧分压(PaO 2)、动脉血氧饱和度(SaO 2)、氧合指数(OI)水平高于对照组,动脉血二氧化碳分压(PaCO 2)水平低于对照组(P<0.05);观察组治疗后白介素6/8(IL-6/8)、高迁移率族蛋白(HMGB-1)、可溶性髓系细胞触发受体-1(sTREM-1)水平低于对照组(P<0.05)。结论在BAL治疗的基础上联合使用高频振动排痰,可有效增加患儿排痰量,提高呼吸功能,改善血气指标,降低机体炎性反应,加快患儿恢复进程。
Objective To explore the application effect of bronchoalveolar lavage(BAL)combined with vibration expectoration in children with pneumonia.Methods 52 children with severe pneumonia were enrolled in the hospital between April 2019 and July 2022 and were randomly divided into observation group and control group,with 26 cases in each group.The control group was treated with BAL,while observation group was treated with vibration expectoration before BAL.All were treated for 7d.The clinical curative effect,clinical recovery,respiratory function,blood gas indexes,inflammatory indexes and the occurrence of adverse reactions were compared between the two groups.Results The difference in response rate of clinical treatment between the two groups was not statistically significant(P>0.05).The daily sputum output in observation group was more than that in control group,and mechanical ventilation time and stay time in ICU were shorter than those in control group(P<0.05).The difference in 28d mortality between the two groups was not statistically significant(P>0.05).After treatment,peak inspiratory pressure(PIP),airway resistance(RAW)and work of breathing(WOB)in observation group were lower than those in control group,while dynamic lung compliance(CLdyn)was higher than that in control group(P<0.05).After treatment,partial pressure of oxygen(PaO 2),oxygen saturation(SaO2)and oxygenation index(OI)in observation group were higher than those in control group,while partial pressure of carbon dioxide(PaCO2)was lower than that in control group(P<0.05).After treatment,levels of serum interleukin 6/8(IL-6/8),high mobility group protein B1(HMGB-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in observation group were lower than those in control group(P<0.05).The difference in incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion BAL combined with high-frequency vibration expectoration can effectively increase sputum output,improve respiratory function and blood
作者
戴海英
王芳
张婷
洪垚
DAI Haiying;WANG Fang;ZHANG Ting;HONG Yao(Department of Paediatrics,Yijishan Hospital of the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《湖北民族大学学报（医学版）》
2023年第4期38-42,共5页
Journal of Hubei Minzu University(Medical Edition)
基金
皖南医学院弋矶山医院三新项目(Y22087)。
关键词
重症肺炎
患儿
纤支镜肺泡灌洗
振动排痰
Severe pneumonia
Children
Bronchoalveolar lavage
Vibration expectoration
