纤维支气管镜吸痰结合肺泡灌洗对COPD并呼吸衰竭患者CRP水平及机械通气时间的改善效果

Effect of fiberoptic bronchoscope sputum suction combined with alveolar lavage on improvement of CRP level and mechanical ventilation time in patients with COPD and respiratory failure

目的研究慢性阻塞性肺疾病(COPD)并呼吸衰竭患者采用纤维支气管镜吸痰结合肺泡灌洗对其CRP水平与机械通气时间的改善效果。方法79例COPD并呼吸衰竭患者,随机分成常规组(39例)及治疗组(40例)。常规组采用常规治疗,治疗组在常规治疗的基础上采用纤维支气管镜吸痰结合肺泡灌洗治疗。比较两组疗效,治疗前后的降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)血清炎性应激指标水平,机械通气时间、肺啰音消失时间、咳嗽消失时间、咳痰消失时间。结果治疗组患者的总有效率为95.00%,高于常规组的79.49%,差异有统计学意义(P<0.05)。治疗前,两组患者的PCT、CRP、IL-6水平对比,差异均无统计学意义(P>0.05);治疗后,治疗组患者的PCT、CRP、IL-6水平均低于常规组,差异均有统计学意义(P<0.05)。治疗组患者的肺啰音消失时间、咳嗽消失时间、咳痰消失时间、机械通气时间分别为(5.63±0.84)、(13.28±1.38)、(8.27±1.19)、(5.23±3.16)d,均短于常规组的(12.86±2.62)、(19.52±2.47)、(12.44±2.35)、(9.62±5.26)d,差异均有统计学意义(P<0.05)。结论COPD并呼吸衰竭患者采用纤维支气管镜吸痰结合肺泡灌洗疗效显著,能减少机械通气时间,同时改善PCT、IL-6、CRP等血清炎性应激指标水平,适合进一步推广。

Objective To study the effect of fiberoptic bronchoscope sputum suction combined with alveolar lavage on improvement of CRP level and mechanical ventilation time in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods A total of 79 patients with COPD and respiratory failure were randomly divided into conventional group(39 cases)and treatment group(40 cases).The conventional group received conventional therapy,and the treatment group received fiberoptic bronchoscope sputum suction combined with alveolar lavage on the basis of the conventional therapy.The efficacy,serum inflammatory stress index levels of procalcitonin(PCT),interleukin-6(IL-6),and C-reactive protein(CRP)before and after treatment,mechanical ventilation time,lung rales disappearance time,cough disappearance time,expectoration disappearance time were compared between the two groups.Results The total effective rate of the treatment group was 95.00%,which was higher than that of conventional group 79.49%,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in levels of PCT,CRP and IL-6 between the two groups(P>0.05).After treatment,the levels of PCT,CRP and IL-6 of the treatment group was lower than that of conventional group,and the difference was statistically significant(P<0.05).The lung rales disappearance time,cough disappearance time,expectoration disappearance time and mechanical ventilation time of the treatment group was(5.63±0.84),(13.28±1.38),(8.27±1.19)and(5.23±3.16)d,which was shorter than that of the control group(12.86±2.62),(19.52±2.47),(12.44±2.35)and(9.62±5.26)d,and the difference was statistically significant(P<0.05).Conclusion Fiberoptic bronchoscope sputum suction combined with alveolar lavage has a significant effect in patients with COPD and respiratory failure,which can reduce the time of mechanical ventilation,and at the same time improve the PCT,IL-6,CRP and other serum inflammatory stress indicators.It is suitable for further promotion.