| 闫登峰,朱春雨,胡淼.血必净联合纤维支气管镜吸痰灌洗治疗重症肺炎的疗效及对血清炎性因子水平的影响[J].安徽医药,2020,24(4):759-762. |
| 血必净联合纤维支气管镜吸痰灌洗治疗重症肺炎的疗效及对血清炎性因子水平的影响 |
| Xuebijing combined with sputum aspiration and bronchoalveolar lavage via fiberoptic bronchoscope in treatment of severe pneumonia and the effects on serum inflammatory cytokines level |
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| DOI：10.3969/j.issn.1009?6469.2020.04.031 |
| 中文关键词: 肺炎 支气管肺泡灌洗 支气管镜检查 血必净 呼吸，人工 血气分析 肿瘤坏死因子 α 降钙素基因相关肽 C反应蛋白质 |
| 英文关键词: Pneumonia Bronchoalveolar lavage Bronchoscopy Xuebijing Respiration,artificial Blood gas analysis Tu? mor necrosis factor?alpha Calcitonin gene?related peptide C?reactive protein |
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| 中文摘要: |
| 目的探讨血必净联合纤维支气管镜吸痰灌洗治疗重症肺炎病人的疗效及对血清炎性因子水平的影响。方法将周口市中心医院呼吸重症监护病房 2018年 3月至 2019年 2月收治的 104例重症肺炎病人按随机数字表法分为对照组( n＝50)和试验组( n＝54)，对照组应用纤维支气管镜吸痰灌洗，试验组给予血必净 +纤维支气管镜吸痰灌洗治疗，比较两组治疗后疗效、机械通气时间、抗菌药物治疗使用时间、肺啰音消失时间、 ICU住院时间，治疗前后氧分压( PaO2)、二氧化碳分压( PaCO2)、血氧饱和度( SpO2)和血清肿瘤坏死因子 ?a(TNF?α)、降钙素原( PCT)、 C反应蛋白( CRP)水平等。结果治疗 7d后，试验组总体疗效优于对照组( P＜0.05)；治疗后，试验组机械通气时间( 6.19±1.39)d、肺啰音消失时间( 6.28±1.49)d、抗菌药物治疗使用时间(5.93±1.32)d和 ICU住院时间( 13.19±2.49)d显著短于对照组的( 9.26±1.39)d、(10.24±2.20)d、(9.62±1.54)d、(17.84±3.24)d(P＜0.05)；治疗前两组 PaCO2、PaO2、SpO2及血清 TNF?α、PCT、CRP水平组间比较均差异无统计学意义( P＞0.05)治疗后试验组 PaO2SpO2(84.62±6.82)%，(43.07±3.6，(83.24±6.50)mmHg、(93.16±7.29)%高于对照组的( 73.53±5.76)mmHg、PaCO21)mmHg和血清 TNF?α(51.29±6.68)ng/L、PCT(0.59±0.13)pg/L、CRP(23.66±3.06)mg/L水平低于对照组的( 47.27±3.82)mmHg、(65.34±7.12) ng/L、(1.38±0.39)pg/L、(41.63±5.18)mg/L，差异有统计学意义( P＜0.05)。结论血必净联合纤维支气管镜吸痰灌洗可降低重症肺炎机体炎症反应程度，改善血气分析指标，缩短 ICU住院时间，提高临床疗效。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of Xuebijing combined with sputum aspiration and bronchoalveolar lavage viafiberoptic bronchoscope in treatment of severe pneumonia and the effects on serum inflammatory cytokines level.Methods From March 2018 to February 2019，104 patients with severe pneumonia admitted to Respiratory Intensive Care Unit of Zhoukou Cen?tral Hospital were assigned into control group(n＝50)and experimental group(n＝54)by numerical random table method.Thecontrol group received fiberoptic bronchoscopic sputum aspiration and bronchoalveolar lavage，while the experimental group re? ceived Xuebijing combined with fiberopric bronchoscopy sputum aspiration and bronchoalveolar lavage.A comparison was made ofthe clinical efficacy，mechanical ventilation time，time of using antibacterial drug，time of disappearance of lung voice，stay in ICU， and the change in levels of partial pressure of oxygen(PaO2)，partial pressure of carbon dioxide(PaCO2)，blood oxygen saturation(SpO2)and serum tumor necrosis factor?α(TNF?α)，procalcitonin(PCT)，C?reactive protein(CRP)before and after treatment were compared between two groups.Results After 7d treatment，The clinical efficacy of the experimental group was better than that of the control group(P＜0.05).After treatment，the mechanical ventilation time，time of disappearance of lung voice，time of us? ing antibacterial drug，and stay in ICU in the experimental group were significantly shorter than those of the control group［(6.19±1.39)d vs.(9.26±1.39)d，(6.28±1.49)d vs.(10.24±2.20)d，(5.93±1.32)d vs.(9.62±1.54)d，(13.19±2.49)d vs.(17.84±3.24)d，re? spectively；P＜0.05］.Before treatment，there were no significant differences in PaO2，PaCO2，SpO2 and serum TNF?α，PCT，CRP lev? els between two groups(P＞0.05).After treatment，PaO2，SpO2of the experimental group were significantly higher than those in the control group［(83.24±6.50)mmHg vs.(73.53±5.76)mmHg，(93.16±7.29)% vs.(84.62±6.82)%，respectively；P＜0.05］，PaCO2and serum TNF?α，PCT，CRP levels of the experimental group were significantly lower than those in the control group［( 43.07±3.61)mmHg vs.(47.27±3.82)mmHg，(51.29±6.68)ng/L vs.(65.34±7.12)ng/L，(0.59±0.13)pg/L vs.(1.38±0.39)pg/L，(23.66±3.06)mg/L vs.(41.63±5.18)mg/L，respectively；P＜0.05］.Conclusion Xuebijing combined with sputum aspiration and bronchoalveolar lavagevia fiberopric bronchoscope can reduce the inflammatory response of patients with severe pneumonia，improve blood gas analysis in? dex，shorten hospital stay in ICU，and improve clinical efficacy. |
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