纤维支气管镜下支气管肺泡灌洗治疗重症肺部感染的临床效果
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摘要
目的探讨纤维支气管镜下支气管肺泡灌洗治疗重症肺部感染的效果。方法选取2016年5月～2018年11月在我院治疗的126例重症肺部感染患者,按照随机数字表法分为对照组和实验组,每组均63例。对照组患者给予常规治疗,实验组患者应用纤维支气管镜下支气管肺泡灌洗治疗,观察比较两组患者的治疗效果、临床症状消失时间、呼吸力学参数。结果实验组患者的治疗总有效率为95.24%,明显高于对照组的80.96%,差异有统计学意义(P<0.05)。实验组患者的肺部啰音消失时间、咳痰消失时间、咳嗽消失时间均短于对照组,差异有统计学意义(P<0.05)。实验组患者治疗后的肺顺应性、胸廓顺应性、总动态顺应性均显著高于对照组,差异有统计学意义(P<0.05)。结论针对重症肺部感染患者应用纤维支气管镜下支气管肺泡灌洗治疗可提高治疗效果,改善临床症状及呼吸力学参数,促进患者康复,值得推广应用。
Objective To investigate the efficacy of bronchoalveolar lavage under fiberoptic bronchoscope in the treatment of severe pulmonary infection. Methods A total of 126 patients with severe pulmonary infection treated in our hospital from May 2016 to November 2018 were selected and divided into the control group and the experimental group according to random number table method, 63 cases in each group. Patients in the control group were given routine treatment, while patients in the experimental group were given bronchoalveolar lavage under fiberoptic bronchoscope.The therapeutic effect, disappearance time of clinical symptoms and respiratory mechanics parameters of the two groups were observed and compared. Results The total effective rate of the experimental group was 95.24%, which was significantly higher than that of the control group(80.96%), with significant difference(P<0.05). The time of lung rale disappearance, sputum disappearance and cough disappearance in the experimental group were shorter than those in the control group, with significant difference(P<0.05). The lung compliance, thoracic compliance and total dynamic compliance of the experimental group after treatment were significantly higher than those of the control group, with significant difference(P<0.05). Conclusion Bronchoalveolar lavage under fiberoptic bronchoscope can improve the therapeutic effect, clinical symptoms and respiratory mechanics parameters, and promote the rehabilitation of patients with severe pulmonary infection. It is worth popularizing and applying.
Objective To investigate the efficacy of bronchoalveolar lavage under fiberoptic bronchoscope in the treatment of severe pulmonary infection. Methods A total of 126 patients with severe pulmonary infection treated in our hospital from May 2016 to November 2018 were selected and divided into the control group and the experimental group according to random number table method, 63 cases in each group. Patients in the control group were given routine treatment, while patients in the experimental group were given bronchoalveolar lavage under fiberoptic bronchoscope.The therapeutic effect, disappearance time of clinical symptoms and respiratory mechanics parameters of the two groups were observed and compared. Results The total effective rate of the experimental group was 95.24%, which was significantly higher than that of the control group(80.96%), with significant difference(P<0.05). The time of lung rale disappearance, sputum disappearance and cough disappearance in the experimental group were shorter than those in the control group, with significant difference(P<0.05). The lung compliance, thoracic compliance and total dynamic compliance of the experimental group after treatment were significantly higher than those of the control group, with significant difference(P<0.05). Conclusion Bronchoalveolar lavage under fiberoptic bronchoscope can improve the therapeutic effect, clinical symptoms and respiratory mechanics parameters, and promote the rehabilitation of patients with severe pulmonary infection. It is worth popularizing and applying.
引文
[1]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.
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[5]Zoltowska AM,LeiY,Fuchs B,et al.The interleukin-33 receptor ST2 is important for the development of peripheral airway hyperresponsiveness and inflammation in a house dust mite mouse model of asthma[J].Clin Exp Aller,2016,46(3):479-490.
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[7]李巧荣,贾海燕,葛均克.纤维支气管镜肺泡灌洗联合盐酸氨溴索静脉滴注治疗重症肺部感染效果观察[J].山东医药,2018,58(6):55-57.
[8]马孝武,韩学昌,苗亚飞,等.双腔气管内插管单肺通气下行支气管肺泡灌洗术用于肺部感染的治疗效果研究[J].中华医院感染学杂志,2017,27(14):3165-3168.
[9]石泽亚,秦月兰,祝益民,等.纤维支气管镜肺泡灌洗联合振动排痰治疗重症肺炎机械通气患者的效果观察:一项286例患者前瞻性随机对照研究[J].中华危重病急救医学,2017,29(1):66-70.
[10]陈立,李兰,韩悦,等.通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者HMGB-1、IL-10水平影响[J].重庆医学,2016,45(25):3485-3487.
[11]Chen W,Xia J,Hu P,et al.Follistatin-like 1 protects cardiomyoblasts from injury induced by sodium nitroprusside through modulating Akt and Smad1/5/9 sig naling[J].Biochem Biophys Res Commun,2016,469(3):418-423.
[12]陈实,李承红.电子支气管镜在重症破伤风合并肺部感染患者中的应用观察[J].中国内镜杂志,2016,22(11):34-37.
[13]吕绍翔,霍敏琴.盐酸氨溴索支气管肺泡灌洗对慢性阻塞性肺疾病合并肺部感染的疗效[J].广东医学,2016,37(S2):228-229.
[14]Zhang ZM,Zhang AR,Xu M,et al.TLR-4/miRNA-32-5p/FSTL1 signaling regulates mycobacterial survival and inflammatory responses in Mycobacterium tuberculosis-infected macrophages[J].Exp Cell Res,2017,352(2):313-321.
[15]唐安珏,宋卫东,徐平.支气管肺泡灌洗液对免疫功能正常肺曲霉病患者的早期诊断价值[J].中国内镜杂志,2017,23(11):24-29.
[16]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.
[17]张如瑞,赵静,张菊,等.纤维支气管镜灌洗在机械通气患者肺部感染中的应用价值及对炎性因子的影响[J].中华医院感染学杂志,2017,27(1):98-100.
[18]杨兆辉,段瑞祥,杨晶,等.纤维支气管镜与肺泡灌洗术治疗老年重症肺部感染患者的疗效分析[J].中华医院感染学杂志,2016,26(6):1300-1302.
[2]石泽亚,秦月兰,祝益民,等.振动排痰联合纤维支气管镜肺灌洗治疗重症肺炎机械通气患者的临床研究[J].中国内镜杂志,2016,22(10):1-5.
[3]徐小彭,李敏雄,黄永鹏,等.纤维支气管镜联合氨溴索肺泡灌洗治疗脑梗死患者重症肺部感染伴肺不张的临床效果分析[J].中华医院感染学杂志,2016,26(12):2697-2699.
[4]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.
[5]Zoltowska AM,LeiY,Fuchs B,et al.The interleukin-33 receptor ST2 is important for the development of peripheral airway hyperresponsiveness and inflammation in a house dust mite mouse model of asthma[J].Clin Exp Aller,2016,46(3):479-490.
[6]敖勇.纤维支气管镜肺泡灌洗对重症肺炎伴呼吸衰竭患者呼吸功能及炎症活动的影响[J].宁夏医科大学学报,2016,38(3):310-313.
[7]李巧荣,贾海燕,葛均克.纤维支气管镜肺泡灌洗联合盐酸氨溴索静脉滴注治疗重症肺部感染效果观察[J].山东医药,2018,58(6):55-57.
[8]马孝武,韩学昌,苗亚飞,等.双腔气管内插管单肺通气下行支气管肺泡灌洗术用于肺部感染的治疗效果研究[J].中华医院感染学杂志,2017,27(14):3165-3168.
[9]石泽亚,秦月兰,祝益民,等.纤维支气管镜肺泡灌洗联合振动排痰治疗重症肺炎机械通气患者的效果观察:一项286例患者前瞻性随机对照研究[J].中华危重病急救医学,2017,29(1):66-70.
[10]陈立,李兰,韩悦,等.通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者HMGB-1、IL-10水平影响[J].重庆医学,2016,45(25):3485-3487.
[11]Chen W,Xia J,Hu P,et al.Follistatin-like 1 protects cardiomyoblasts from injury induced by sodium nitroprusside through modulating Akt and Smad1/5/9 sig naling[J].Biochem Biophys Res Commun,2016,469(3):418-423.
[12]陈实,李承红.电子支气管镜在重症破伤风合并肺部感染患者中的应用观察[J].中国内镜杂志,2016,22(11):34-37.
[13]吕绍翔,霍敏琴.盐酸氨溴索支气管肺泡灌洗对慢性阻塞性肺疾病合并肺部感染的疗效[J].广东医学,2016,37(S2):228-229.
[14]Zhang ZM,Zhang AR,Xu M,et al.TLR-4/miRNA-32-5p/FSTL1 signaling regulates mycobacterial survival and inflammatory responses in Mycobacterium tuberculosis-infected macrophages[J].Exp Cell Res,2017,352(2):313-321.
[15]唐安珏,宋卫东,徐平.支气管肺泡灌洗液对免疫功能正常肺曲霉病患者的早期诊断价值[J].中国内镜杂志,2017,23(11):24-29.
[16]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.
[17]张如瑞,赵静,张菊,等.纤维支气管镜灌洗在机械通气患者肺部感染中的应用价值及对炎性因子的影响[J].中华医院感染学杂志,2017,27(1):98-100.
[18]杨兆辉,段瑞祥,杨晶,等.纤维支气管镜与肺泡灌洗术治疗老年重症肺部感染患者的疗效分析[J].中华医院感染学杂志,2016,26(6):1300-1302.