BIPAP辅助纤维支气管镜肺泡灌洗对ICU重症肺炎合并呼吸衰竭患者的疗效

Effect of BIPAP Assisted Bronchoalveolar Lavage on ICU Patients with Severe Pneumonia and Respiratory Failure

目的:分析双水平气道正压通气(BIPAP)辅助纤维支气管镜肺泡灌洗对重症监护室(ICU)重症肺炎合并呼吸衰竭患者的疗效。方法:回顾性分析2021年4月至2023年4月莆田学院附属医院收治的98例ICU重症肺炎合并呼吸衰竭患者的临床资料,按治疗措施的不同分为对照组和观察组。其中单纯行BIPAP的47例患者纳入对照组,行BIPAP辅助纤维支气管镜肺泡灌洗治疗的51例患者纳入观察组,均持续治疗1周。比较两组患者临床疗效、呼吸功能指标、血气分析指标、炎症因子水平。结果:观察组患者临床疗效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者呼吸频率、氧合指数、动态顺应性均优于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者动脉血氧分压(PaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者血清C反应蛋白(CRP)、降钙素原(PCT)水平、白细胞(WBC)计数均低于对照组,差异具有统计学意义(P<0.05)。结论:BIPAP辅助纤维支气管镜肺泡灌洗对ICU重症肺炎合并呼吸衰竭患者的疗效显著,能够减轻患者机体炎症反应,改善呼吸功能与血气分析指标,促进临床症状消退。

Objective To analyze the efficacy of bilevel positive airway pressure ventilatior(BIPAP)assisted bronchoalveolar lavage in severe pneumonia patients with respiratory failure in the intensive care unit(ICU).Methods A retrospective analysis was conducted on the clinical data of 98 ICU patients with severe pneumonia and respiratory failure admitted to Putian University Affiliated Hospital from April 2021 to April 2023.They were divided into a control group and an observation group according to different treatment measures.Among them,47 patients who received BIPAP alone were included in the control group,while 51 patients who received BIPAP assisted bronchoalveolar lavage treatment were included in the observation group,all of whom continued treatment for one week.Compare the clinical efficacy,respiratory function indicators,blood gas analysis indicators,and inflammatory factor levels between two groups of patients.Results The clinical treatment efficiency of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the respiratory rate,oxygenation index,and dynamic compliance of the observation group were better than those of the control group,with statistically significant differences(P<0.05).After treatment,the arterial partial pressure of oxygen(PaO_(2))of the observation group was higher than that of the control group,and the arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that of the control group,with statistically significant differences(P<0.05).After treatment,the levels of serum C-reactive protein(CRP),procalcitonin(PCT),and white blood cell(WBC)count in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion BIPAP assisted bronchoalveolar lavage has a significant therapeutic effect on ICU patients with severe pneumonia combined with respiratory failure.It can reduce the inflammatory response of the patient's body,improve respiratory function and blood gas analysis indicators,promote clinical symptom resolution,and has certain application value.