纤支镜肺泡灌洗治疗慢阻肺急性加重期炎性指标的影响及疗效

Clinical effect and influence of alveolar wash by fiber bronchoscope on inflammatory index(serum PCT,CRP and WBC) in treatment of AECOPD

目的观察纤维支气管镜肺泡灌洗治疗慢性阻塞性肺疾病急性加重期(AECOPD)的炎性指标血清降钙素原(PCT)、C-反应蛋白(CRP)及全血白细胞(WBC)变化趋势及临床疗效。方法选自2015年09月至2016年03月在我院呼吸科住院治疗诊断为慢性阻塞性肺疾病急性加重期患者105例,用随机数字法将入选的患者分为肺泡灌洗(Alveolar wash group,AW)组51例和常规对照(Normal control group,NC)组54例。常规给予抗感染、解支气管痉挛、化痰、呼吸支持等治疗,对照组给予相同处理,不使用纤维支气管镜肺泡灌洗治疗。肺泡灌洗组在以上方案上再加用纤维支气管镜肺泡灌洗。观察患者第1、3、6、9d血清PCT、CRP及全血WBC检测数值及住院时间。结果治疗后3、6、9 d肺泡灌洗组和对照组PCT、CRP、WBC测定结果比较,差异有统计学意义(P<O.05),肺泡灌洗组住院时间为(11.5±3.5)d,常规对照组住院天数为(16.5±4.3)d,明显短于对照组,差异有统计学意义(P<O.05)。结论纤维支气管镜肺泡灌洗治疗慢性阻塞性肺疾病急性加重期安全有效,可以明显促进炎症吸收恢复,缩短抗生素药物使用时间和住院时间。

Objective To observe the clinical effect and influence of alveolar wash by fiber bronchoscope on inflammatory index （serum PCT, CRP and WBC） in treatment of AECOPD. Methods From September 2015 to March 2016, a total of 105 cases of AECOPD were randomly divided into the alveolar wash group （ AW, n = 51 ） and the normal control group （ NC, n = 54）. The conventional treatment included anti infection, solution of bronchial spasm, Expectorant, respiratory support, etc. On the basis of the above scheme, the alveolar wash group was added with alveolar wash by fiber bronchoscope. The value of serum PCT, CRP and WBC 1,3, 6 and 9 days after treatment and the duration of hospital stay were analyzed. Results The results of PCT, CRP and WBC showed significant difference between the alveolar wash group and the control group 3, 6 and 9 days after treatmen （ P 〈 0. 05 ）, and the duration of hospital stay was （11.5 ± 3.5）d in the AW group and （16. 5 ±4. 3 ）d in the control group （P 〈0. 05）. Conclusion Alveolar wash by fiber bronchoscope is safe and effective in treatment of AECOPD patients, which can obviously promote the recovery of inflammatory absorption, and shorten the time of use of antibiotics and hospital stay.