依替米星支气管肺泡灌洗治疗重症肺炎临床观察

Bronchoalveolar Lavage with Etimicin in Treating Severe Pneumonia

目的探讨经支气管镜注入依替米星行肺泡灌洗治疗重症肺炎的疗效及对患者血气指标的影响。方法选取泰州市第二人民医院2016年1月至2018年7月收治的重症肺炎患者60例,按随机分配原则分为观察组和对照组,各30例。对照组患者常规给予依替米星静脉滴注,连续治疗5 d;观察组患者经支气管镜注入依替米星行肺泡灌洗治疗。结果治疗后,观察组患者的动脉血氧分压(PaO2)、血氧饱和度(SpO2)水平均高于对照组,动脉血二氧化碳分压(PaCO2)低于对照组(P <0. 05);观察组患者氧合指数(PaO2/FiO2)、动态肺顺应性(Cdyn)均高于对照组,呼吸功能(WOB)低于对照组(P <0. 05);观察组患者的炎性因子水平包括C反应蛋白(CRP)、血清降钙素原(PCT)、白细胞介素1β(IL-1β)水平均低于对照组(P <0. 05)。观察组不良反应发生率为13. 33%(4/30),与对照组的6. 67%(2/30)相当(P> 0. 05)。结论经支气管镜注入依替米星行肺泡灌洗治疗重症肺炎,可改善患者的血气指标、呼吸功能、炎性因子水平。

Objective To investigate the application of bronchoalveolar lavage with etimicin in the treatment of severe pneumonia and its influence on blood gas analysis. Methods A total of 60 patients with severe pneumonia treated in the hospital from January 2016 to July 2018 were selected and divided into the observation group and the control group according to the principle of random distribution,30 cases in each group. The control group was routinely treated with etimicin intravenous injection,while the observation group was treated with bronchoalveolar lavage with etimicin. Results After treatment,the levels of arterial partial pressure of oxygen( PaO2) and oxygen saturation( SpO2) in the observation group were higher than those in the control group,while the level of arterial partial pressure of carbon dioxide( PaCO2) was lower than that in the control group( P < 0. 05);the levels of Oxygenation index( PaO2/FiO2) and dynamic lung compliance( Cdyn) in the observation group were higher than those in the control group,while the level of work of breathing( WOB) was lower than that in the control group( P < 0. 05);the levels of inflammatory factors,including C-reactive protein( CRP),procalcitonin( PCT),interleukin-1 beta( IL-1 beta) in the observation group were lower than those in the control group( P< 0. 05). The incidence of adverse reactions was 13. 33%( 4/30) in the observation group and 6. 67%( 2/30) in the control group,with was no statistical difference between the two groups( P > 0. 05). Conclusion Bronchoalveolar lavage with etimicin in the treatment of severe pneumonia,which can improve the blood gas index,respiratory function and inflammatory factor level of patients.