纤维支气管镜吸痰联合亚胺培南-西司他丁钠治疗重症肺部感染的效果及对患者肺功能的影响

Effect of fiberoptic bronchoscopy sputum aspiration combined with imipenem-cilastatin sodium in the treatment of severe pulmonary infection and its impact on pulmonary function

目的研究纤维支气管镜吸痰联合亚胺培南-西司他丁钠治疗重症肺部感染的效果及对患者肺功能的影响。方法选取2015年9月至2018年10月于我院接受治疗的重症肺部感染患者95例,按随机抽签法将其分为观察组(48例)与对照组(47例)。对照组采用亚胺培南-西司他丁钠治疗,观察组在对照组基础上采用经纤维支气管镜吸痰治疗。比较两组治疗效果、血清炎症因子水平、临床症状改善情况、机械通气时间、住院时间及肺功能。结果观察组治疗总有效率为85.42%,高于对照组的68.09%(P<0.05)。治疗后,两组患者血清CRP、MIP-1α、PCT水平均低于治疗前,且观察组低于对照组(P<0.05)。观察组患者体温恢复正常时间、血常规恢复正常时间、临床症状消失时间、机械通气时间及住院时间均短于对照组(P<0.05)。治疗后,观察组患者MMV、MMEF、FRC、TLC及FEV1/FVC均高于治疗前和对照组(P<0.05)。结论纤维支气管镜吸痰联合亚胺培南-西司他丁钠治疗重症肺部感染患者,可缩短机械通气时间及症状消失时间,降低血清炎症因子水平,改善肺功能,提高临床治疗效果。

Objective To study the effect of fiberoptic bronchoscopy sputum aspiration combined with imipenem-cilastatin sodium in the treatment of severe pulmonary infection and its impact on pulmonary function.Methods Ninety-five patients with severe pulmonary infection treated in our hospital from September 2015 to October 2018 were selected and divided into observation group(48 cases)and control group(47 cases)by random drawing method.The control group was treated with imipenem-cilastatin sodium,while the observation group was treated with sputum aspiration through fiberoptic bronchoscope on the basis of the control group.The therapeutic effects,serum inflammatory factors,clinical symptoms,mechanical ventilation time,hospitalization time and pulmonary function were compared between the two groups.Results The total effective rate of treatment in the observation group(85.42%)was higher than that of the control group(68.09%)(P<0.05).After treatment,the levels of CRP,MIP-1α and PCT in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).The time of recovery of body temperature,blood routine and clinical symptoms,mechanical ventilation time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).After treatment,the MMV,MMEF,FRC,TLC and FEV1/FVC in the observation group were higher than those before treatment and in the control group,and the differences were statistically significant(P<0.05).Conclusion Fiberoptic bronchoscopy sputum aspiration combined with imipenem-cilastatin sodium in the treatment of severe pulmonary infection can shorten the time of mechanical ventilation and symptoms disappearance,reduce the level of serum inflammatory factors,improve lung function and enhance clinical therapeutic effect.