纤维支气管镜肺灌洗在机械通气合并肺部感染患者中的应用效果
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摘要
目的探讨纤维支气管镜肺灌洗在机械通气合并肺部感染患者中的应用效果。方法选取2017年6月～2018年6月我院收治的92例机械通气合并肺部感染患者作为研究对象,按随机数字表法分为对照组(46例)和观察组(46例),对照组采取常规治疗,观察组采取常规治疗联合纤维支气管肺灌洗治疗。治疗1周后,对两组的治疗情况进行观察,并比较两组的治疗总有效率、治疗前后降钙素原(PCT)、白细胞(WBC)计数、C-反应蛋白(CRP)以及血气指标的变化,血气指标包括血氧饱和度(SaO_2)、动脉血氧分压(PaO_2)和动脉血二氧化碳分压(PaCO_2)。结果观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组治疗后的PCT、CRP、WBC水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);两组治疗后的SaO_2、PaO_2水平高于治疗前,PaCO_2水平低于治疗前,且观察组治疗后的SaO_2、PaO_2水平高于对照组,PaCO_2水平低于对照组,差异均有统计学意义(P<0.05)。结论纤维支气管镜肺灌洗治疗能促进痰液的排出,改善机械通气合并肺部感染患者的炎症指标和血气指标,值得临床推广应用。
Objective To expolre the application effect of bronchoscopic lung lavage in patients with mechanical ventilation combined with pulmonary infection.Methods A total of 92 patients with mechanical ventilation combined with pulmonary infection in our hospital from June 2017 to June 2018 were selected as the study subjects,they were divided into control group(46 cases) and observation group(46 cases) according to random number table method,the control group received routine treatment,while the observation group received routine treatment combined with bronchofibrous lung lavage.After one week of treatment,the total effective rate,procalcitonin(PCT),white blood cell(WBC) count,Creactive protein(CRP) and blood gas indexes of the two groups were observed and compared,blood gas indexes included blood oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2) and arterial partial pressure of carbon dioxide(PaCO2).Results The total effective rate of the observation group was higher than that of the control group,the difference was significant(P<0.05).The levels of CT,CRP and WBC in the two groups after treatment were lower than those before treatment,and those in the observation group were lower than in the control group,the differences were significant(P<0.05).After treatment,the levels of SaO2 and PaO2 in both groups were higher than those before treatment,and the levels of PaCO2 were lower than those before treatment,after treatment,the levels of SaO2 and PaO2 in the observation group were higher than those in the control group,and the levels of PaCO2 in the observation group were lower than those in the control group,the differences were significant(P<0.05).Conclusion Fiberoptic bronchoscope lung lavage therapy can promote sputum discharge,improve inflammatory and blood gas indicators in patients with mechanical ventilation combined with pulmonary infection,which is worthy of clinical application.
Objective To expolre the application effect of bronchoscopic lung lavage in patients with mechanical ventilation combined with pulmonary infection.Methods A total of 92 patients with mechanical ventilation combined with pulmonary infection in our hospital from June 2017 to June 2018 were selected as the study subjects,they were divided into control group(46 cases) and observation group(46 cases) according to random number table method,the control group received routine treatment,while the observation group received routine treatment combined with bronchofibrous lung lavage.After one week of treatment,the total effective rate,procalcitonin(PCT),white blood cell(WBC) count,Creactive protein(CRP) and blood gas indexes of the two groups were observed and compared,blood gas indexes included blood oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2) and arterial partial pressure of carbon dioxide(PaCO2).Results The total effective rate of the observation group was higher than that of the control group,the difference was significant(P<0.05).The levels of CT,CRP and WBC in the two groups after treatment were lower than those before treatment,and those in the observation group were lower than in the control group,the differences were significant(P<0.05).After treatment,the levels of SaO2 and PaO2 in both groups were higher than those before treatment,and the levels of PaCO2 were lower than those before treatment,after treatment,the levels of SaO2 and PaO2 in the observation group were higher than those in the control group,and the levels of PaCO2 in the observation group were lower than those in the control group,the differences were significant(P<0.05).Conclusion Fiberoptic bronchoscope lung lavage therapy can promote sputum discharge,improve inflammatory and blood gas indicators in patients with mechanical ventilation combined with pulmonary infection,which is worthy of clinical application.
引文
[1]杨雪梅,朱钧,魏娜.纤维支气管镜在ICU并发肺部感染中的临床应用[J].内科急危重症杂志,2014,20(4):268-269.
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[10]王小江,李承红.纤维支气管镜肺泡灌洗对重症呼吸机相关性肺炎患者血清降钙素原和C反应蛋白的影响[J].中国医学装备,2017,14(10):93-96.
[11]黄志雄.纤支镜肺泡灌洗治疗机械通气下重症肺部感染临床观察[J].中国现代药物应用,2015,9(5):166-167.
[12]徐维国,李惠,朱静,等.胸部CT定位后纤维支气管镜气道灌洗在机械通气并发重症肺炎患者中的应用效果[J].中国内镜杂志,2016,22(1):66-69.
[13]Balcan B,Ozcelik U,Ugurlu AO,et al.Increased Mortality Among Renal Transplant Patients With Invasive Pulmonary Aspergillus Infection[J].Prog Transplant,2018,28(4):349-353.
[14]Mortaz E,Sarhifynia S,Marjani M,et al.An adult autosomal recessive chronic granulomatous disease patient with pulmonary Aspergillus terreus infection[J].BMC Infect Dis,2018,18(1):552.
[15]王利,董贞.纤维支气管镜灌洗法治疗重型颅脑损伤患者肺部感染的临床疗效[J].临床肺科杂志,2017,22(9):1602-1604.
[2]Pérez Alves B,Balado Rico M,Esteban Fernández FJ,et al.Pulmonary Thromboembolism As a Complication In Mycobacterium tuberculosis Infection[J].Arch Bronconeumol,2018,54(11):591-592.
[3]王中英.纤维支气管镜肺灌洗对ICU机械通气合并肺部感染老年患者降钙素原和细胞因子的影响[J].中国老年学,2015,35(20):5894-5896.
[4]魏然,朱婉凌.纤维支气管镜肺灌洗治疗机械通气发生肺部感染的临床效果观察[J].现代诊断与治疗,2017,28(13):2499-2500.
[5]白桂红.纤维支气管镜吸痰灌洗治疗呼吸重症监护室肺部感染的临床分析[J].中国临床医生杂志,2014,42(8):47-48.
[6]王川江,徐昉.机械通气合并重症肺部感染患者胸部CT定位下床旁无痛纤维支气管镜气道灌洗临床价值[J].中华急诊医学杂志,2015,24(4):374-379.
[7]王美.纤维支气管镜肺泡灌洗吸痰术治疗ICU重症肺部感染临床效果分析[J].中外医疗,2016,35(24):194-195.
[8]陈刚,徐长青,黄旭晴,等.纤维支气管镜肺灌洗对机械通气患者肺部感染的疗效研究[J].中华医院感染学杂志,2016,26(2):312-313.
[9]崔成宏.纤维支气管镜肺灌洗治疗昏迷合并重症肺部感染的疗效及对PCT、CRP水平的影响[J].中国实用医刊,2017,44(18):7-10.
[10]王小江,李承红.纤维支气管镜肺泡灌洗对重症呼吸机相关性肺炎患者血清降钙素原和C反应蛋白的影响[J].中国医学装备,2017,14(10):93-96.
[11]黄志雄.纤支镜肺泡灌洗治疗机械通气下重症肺部感染临床观察[J].中国现代药物应用,2015,9(5):166-167.
[12]徐维国,李惠,朱静,等.胸部CT定位后纤维支气管镜气道灌洗在机械通气并发重症肺炎患者中的应用效果[J].中国内镜杂志,2016,22(1):66-69.
[13]Balcan B,Ozcelik U,Ugurlu AO,et al.Increased Mortality Among Renal Transplant Patients With Invasive Pulmonary Aspergillus Infection[J].Prog Transplant,2018,28(4):349-353.
[14]Mortaz E,Sarhifynia S,Marjani M,et al.An adult autosomal recessive chronic granulomatous disease patient with pulmonary Aspergillus terreus infection[J].BMC Infect Dis,2018,18(1):552.
[15]王利,董贞.纤维支气管镜灌洗法治疗重型颅脑损伤患者肺部感染的临床疗效[J].临床肺科杂志,2017,22(9):1602-1604.