纤维支气管镜肺灌洗治疗重症肺部感染患者的临床疗效
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摘要
目的对比纤维支气管镜肺灌洗治疗和常规治疗重症肺部感染患者的临床疗效。方法将2015年5月—2017年4月间在我院接受治疗的92例重症肺部感染患者作为研究对象,按照随机数字表分为实验组(n=46)和对照组(n=46),其中对照组采用常规对症治疗,实验组加以实施纤维支气管镜肺灌洗治,治疗后,纤支镜气道灌洗检测两组患者的血气分析指标变化,采用ELISA测定血清炎症因子含量,及放射免疫法测定血清应激激素含量。结果经比较,实验组患者治疗后的PaO_2、SaO_2、PaCO_2高于对照组患者(P<0.05);实验组患者的血清炎症因子hs-CRP、IL-6、IL-8水平低于对照组患者(P<0.05);此外,实验组患者的Ang-Ⅱ、NE、Cor含量低于对照组患者(P<0.05)。结论纤支镜气道灌洗可有助于改善重症肺部感染患者的肺通气功能,降低全身炎症应激程度,促进疾病康复。
Objective To compare the clinical efficacy of bronchoalveolar lavage and conventional treatment in patients with severe pulmonary infection. Methods 92 patients with severe pulmonary infection treated in our hospital from May 2015 to April 2017 were selected as research objects. They were randomly divided into experimental group( n = 46) and control group( n = 46). The control group was treated with conventional symptomatic treatment,The experimental group implemented bronchoscopy lung lavage treatment. After treatment,blood gas bronchoscopic airway lavage in two groups were detected with analysis indexes. Serum inflammatory factors were determined by ELISA,and the serum levels of stress hormones were determined by radioimmunoassay. Results After the treatment,the PaO_2,SaO_2 and PaCO_2 in the experimental group were higher than those in the control group( P < 0. 05). The levels of serum inflammatory factors hs-CRP,IL-6、IL-8 in the experimental group were lower than those in the control group( P < 0. 05); in addition,the levels of Ang-Ⅱ,NE and Cor in the experimental group were lower than those in the control group( P < 0. 05). Conclusion Bronchoscopy airway lavage may help to improve the pulmonary ventilation function of patients with severe pulmonary infection,reduce the degree of systemic inflammatory stress,and promote disease recovery.
Objective To compare the clinical efficacy of bronchoalveolar lavage and conventional treatment in patients with severe pulmonary infection. Methods 92 patients with severe pulmonary infection treated in our hospital from May 2015 to April 2017 were selected as research objects. They were randomly divided into experimental group( n = 46) and control group( n = 46). The control group was treated with conventional symptomatic treatment,The experimental group implemented bronchoscopy lung lavage treatment. After treatment,blood gas bronchoscopic airway lavage in two groups were detected with analysis indexes. Serum inflammatory factors were determined by ELISA,and the serum levels of stress hormones were determined by radioimmunoassay. Results After the treatment,the PaO_2,SaO_2 and PaCO_2 in the experimental group were higher than those in the control group( P < 0. 05). The levels of serum inflammatory factors hs-CRP,IL-6、IL-8 in the experimental group were lower than those in the control group( P < 0. 05); in addition,the levels of Ang-Ⅱ,NE and Cor in the experimental group were lower than those in the control group( P < 0. 05). Conclusion Bronchoscopy airway lavage may help to improve the pulmonary ventilation function of patients with severe pulmonary infection,reduce the degree of systemic inflammatory stress,and promote disease recovery.
引文
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[2]尚茜,商伟娜,翟琳,等.重症肺部感染患者盐酸氨溴索气管镜灌洗对肺功能水平的影响研究[J].中华医院感染学杂志,2015(15):3470-3472.
[3]严宇鹏,王冀,王怡璐,等.俯卧位肺复张对改善重症肺部感染低氧血症患者氧合指数肺内分流作用及对血流动力学的影响分析[J].河北医学,2015(1):16-20.
[4]胡凯,李卜军.纤维支气管镜吸痰联合抗生素灌洗治疗重症肺部感染疗效观察[J].检验医学,2016(b11):55-56.
[5]姚慧娟,曾芳,沈艳琳,等.临床药师优化重症肺部感染患者抗感染药物治疗方案的实践[J].中国药房,2016(14):1989-1991.
[6]杨东星,赵春香.纤维支气管镜肺灌洗联合无创正压通气治疗重症肺部感染的临床效果及其对炎性因子的影响研究[J].实用心脑肺血管病杂志,2016,24(11):32-35.
[7]李砚文,孔树佳,王永顺,等.氨溴索肺泡灌洗治疗脑梗死伴重症肺部感染患者疗效及其对血浆内脂素、PCT、CRP的影响[J].疑难病杂志,2017,16(7):669-672.
[8]赵一文,陈灏.老年慢性阻塞性肺疾病伴肺部感染患者营养不良的临床特点及危险因素分析[J].中华医院感染学杂志,2014(7):1678-1680.
[9]胡循贵,周卫文.肺部感染评分在重症肺炎患者诊断及治疗中的应用价值分析[J].内科,2016,11(2):273-275.
[10]BOSC C,CLEMENT M,DEROUX A,et al.Severe pneumonia due to cytomegalovirus in chronic obstructive pulmonary disease[J].Rev Mal Respir,2014,31(5):435-438.
[11]杨秀智,张海邻.老年肺炎患者血清降钙素原水平检测分析[J].中华医院感染学杂志,2015,25(12):2658-2661.
[12]WAN Q J,HU H F,HE Y C,et al.Severe pneumonia in mycophenolate mofetil combined with low-dose corticosteroids-treated patients with immunoglobulin A nephropathy[J].Kaohsiung J Med Sci,2015,31(1):42-46.
[13]姜正科,俞晓军,朱顺福,等.腹腔镜胃穿孔修补术患者围术期血清白介素、应激激素及氧化应激的变化研究[J].中国内镜杂志,2014,20(5):522-525.
[14]夏玉红,陈宏民,王志新,等.慢性阻塞性肺疾病患者肺部感染对机体应激激素表达状态研究[J].中华医院感染学杂志,2016,26(6):1311-1314.