无创通气联合BAL对吸入性肺炎伴呼衰患者疗效的评价

Evaluation of the effcttion of noninvasive ventilation combined with BAL on patients with aspiration pneumonia complicated with respiratory failure

目的 观察无创通气联合支气管肺泡灌洗（BAL）对吸入性肺炎伴呼衰患者的疗效,评价其临床应用价值.方法 选择住院的吸入性肺炎伴呼衰患者44例,随机分为联合治疗组与常规治疗组,分别于治疗前及治疗后7d观察患者动脉血PH、PaO2、PaCO2、SaO2,静脉血降钙素原（PCT）,FEV1、FEF25～75％、DLCO及胸部CT的变化,采用SPSS 13.0软件分析数据.结果 联合治疗组治疗后,PaO2、SaO2改善较常规治疗组有显著性差异（P＜0.01）,PaCO2差异无显著性（P＞0.05）;PCT下降较常规治疗组有显著性差异（（P＜0.05）;FEF25 ～75％、DLCO改善较常规治疗组有显著性差异（P＜0.01）,FEV1差异无显著性（P＞0.05）;胸部CT病灶吸收较常规治疗组有显著性差异（P＜0.01）.结论 应用无创通气联合BAL技术治疗吸入性肺炎伴呼衰患者,较常规治疗能更快改善呼吸功能,促进肺部炎症吸收,有很好的临床应用价值.

Objective To investigate the effcttion of noninvasive ventilation combined with bronchoalveolar lavage（BAL） on patients with aspiration pneumonia complicated with respiratory failure.Methods Forty-four patients with aspiration pneumonia complicated with respiratory failure were selected,and randomly divided into combined treatment group and routine treatment group.Before and after treatment,the PH,PaO2,PaCO2,SaO2 in arterial blood,Procalcitonin（PCT） in Venous blood,FEVl、FEF25-75％ 、DLcO were measured,and CT of chest were detected.SPSS 13.0 software was used to analyze the data.Results After treatment,the PaO2 、SaO2 of combined treatment group increased significantly compared with those of routine treatment group （P ＜ 0.01）,while the PaCO2 in these two groups had no changes（P ＞ 0.05） ; the concentrations of PCT of combined treatment group decreased significantly compared with those of routine treatment group （P ＜ 0.05） ; FEF25-75％、DLcO of combined treatment group increased significantly compared with those of routine treatment group （P ＜ 0.01）,while FEVl in these two groups had no changes （P ＞ 0.05） ; and the absorption on CT of chest of these two groups also had significandy changes （P ＜ 0.01）.Conclusions Application of noninvasive ventilation combined with BAL in the treatment of patients with aspiration pneumonia complicated with respiratory failure could quickly improve the respiratory function,promote the absorption of pulmonary inflammation,had a good clinical application value.