纤维支气管镜肺泡灌洗治疗对急诊重症肺炎合并呼吸衰竭患者血清学指标的影响

Influence of bronchoalveolar lavage on serum indexes in emergency patients with severe pneumonia complicated with respiratory failure

目的研究分析纤维支气管镜肺泡灌洗在急诊重症肺炎合并呼吸衰竭患者治疗中的临床作用，观察患者血清学指标的变化。方法选取2014年2月至2015年6月收住本院的急性重症肺炎合并不同程度呼吸衰竭的患者81例，依据随机数字表将其分为研究组（n=40）与对照组（n=41）。对照组接受积极抗感染、祛痰以及营养支持等治疗；研究组在此基础上加用纤维支气管镜肺泡灌洗治疗。治疗前及治疗3d后，分别通过血气分析检测组患者动脉血CO2分压（PaCO2）、动脉血氧分压（PaO2），并记录氧合指数（PaO2/FiO2）以及动态顺应性等呼吸功能指标。结果治疗前，2组患者上述指标差异无统计学意义（P〉0．05）。治疗3d后，研究组患者PaO2、PaO2/FiO2以及动态顺应性均高于对照组（P〈0．05），而PaCO2低于对照组（P〈0．05）。结论对急诊重症肺炎合并呼吸衰竭患者采用纤维支气管镜肺泡灌洗可改善患者呼吸功能，有效控制和消除呼吸衰竭症状。

Objective To study the effect of bronchoalveolar lavage for emergency patients with severe pneumonia complicated with respiratory failure and to observe the changes of serum indexes. Methods 81 emergency patients with severe pneumonia complicated with respiratory failure were enrolled and randomly divided into a study group （n=40） and a control group （n=41）. The control group actively took anti-infection, eliminating phlegm, and nutritional support therapy; in addition, the study group were treated with bronchoalveolar lavage. The partial pressures of arterial CO2 （PaCO2） and O2 （PaO2） were detected by blood gas analysis in both groups; and the respiratory function indexes, such as oxygenation index （PaO2/FiO2） and dynamic compliance, were recorded before and 3 days after the treatment. Results There were no statistical differences in the above indexes between these 2 groups before the treatment （P〈0.05）. The PaO2, PaO2/FiO2 and dynamic compliance were higher and the PaCO2 was lower in the study group than in the control group 3 days after the treatment （P〈0.05）. Conclusions Bronchoalveolar lavage for patients with severe pneumonia complicated with respiratory failure can improve their respiratory function and effectively control and eliminate the symptoms of respiratory failure.