纤维支气管镜吸痰联合肺泡灌洗对肺癌术后合并肺部感染患者的疗效分析

Effects of sputum aspiration through fibrobronchoscope combined with alveolar lavage on the patients with pulmonary infection after lung cancer surgery

目的探讨联用纤维支气管镜吸痰与肺泡灌洗治疗对肺癌术后合并肺部感染患者炎性因子及呼吸功能的影响。方法将2018年1月至2019年9月绍兴市人民医院收治的82例肺癌术后合并肺部感染的患者随机分为观察组和对照组,各组均41例。在常规治疗的基础上,观察组行纤维支气管镜吸痰联合肺泡灌洗治疗,对照组行单纯的纤维支气管镜吸痰治疗。评价2组患者的临床疗效,检测血清炎性因子[超敏C反应蛋白(hs-CRP)、IL-8和TNF-α]和呼吸功能(气道阻力、气道峰压、呼吸做功)。结果观察组的临床治疗总有效率为92.68%,对照组为73.17%,组间比较差异具有统计学意义(χ^2=7.353,P<0.05)。治疗后,观察组患者hs-CRP、IL-8、TNF-α指标水平分别为(28.71±4.35)mg/L、(86.27±17.46)pg/mL和(15.36±3.20)pg/mL,均低于对照组(χ^2=7.334、9.223和8.353,P<0.05),平均气道阻力、气道峰压、呼吸做功(8.02±1.24)cmH2O/(L×S)(1 cm H2O=0.098 kPa)、(15.38±1.32)cmH2O和(0.33±0.06)J/L,均低于对照组(χ^2=8.432、7.363和8.712,P<0.05)。结论肺癌术后合并肺部感染的患者予以纤维支气管镜吸痰与肺泡灌洗联合治疗能有效减轻患者的炎性反应,提高呼吸功能,促进临床疗效的提高。

Objective To study the effect of sputum aspiration through fibrobronchoscope combined with alveolar lavage on inflammatory factors and respiratory function in patients with pulmonary infection after lung cancer surgery.Methods Eighty-two cases of lung cancer patients with pulmonary infection after surgery in Shaoxing People’s Hospital from January 2018 to September 2019 were randomly divided into observation group and control group with 41 cases in each group.Based on the conventional therapy,the observation group received fiberobronchoscopy combined with alveolar lavage treatment,while the control group received fiberobronchoscopy.The clinical efficacy in two groups was evaluated.The serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),IL-8 and TNF-α]and respiratory function(airway resistance,peak airway pressure,breathing work)were detected.Results The total effective rates of clinical treatment in observation group and control group were 92.68%and 73.17%,respectively.The difference between the two groups was statistically significant(χ^2=7.353,P<0.05).After treatment,the levels of hs-CRP,IL-8 and TNF-αin the observation group were(28.71±4.35)mg/L,(86.27±17.46)pg/mL and(15.36±3.20)pg/mL,which were lower than those in the control group(χ^2=7.334,9.223 and 8.353,P all<0.05).And mean airway resistance,peak airway pressure,respiratory work were(8.02±1.24)cmH2O/(L×S)(1 cmH2O=0.098 kPa),(15.38±1.32)cmH2O and(0.33±0.06)J/L in the observation group,which were lower than those in the control group(χ^2=8.432,7.363 and 8.712,P<0.05).Conclusions The combined treatment of sputum aspiration through fibrobronchoscope and pulmonary alveolar lavage in patients with pulmonary infection can effectively reduce the inflammatory response,improve respiratory function,and promote clinical efficacy.