纤支镜肺泡灌洗术治疗老年支气管扩张并发急性重症感染的疗效及对炎症指标的影响

Effect of bronchodilatation with bronchoalveolar lavage on acute severe infection in the elderly and its influence on inflammation index

目的观察纤支镜下肺泡灌洗治疗老年支气管扩张并发急性重症感染的疗效及对相关炎症指标的影响。方法将2018年1月至2020年4月间于郑州市中心医院收治的老年支气管扩张并发急性重症感染患者80例随机分为试验组及对照组各40例,对照组仅采用常规治疗方法,试验组在常规治疗的基础上予以肺泡灌洗术的治疗。比较两组患者的临床疗效、肺功能、血气及炎症指标。结果治疗后,试验组的总有效率为92.5%,显著高于对照组的总有效率75.0%;治疗后,两组患者的FEV1%、FEV1/FVC值均显著高于治疗前,且试验组均显著高于对照组;治疗后,两组患者的SaO2、PaO2及PaO2/FiO2均显著高于治疗前,PaCO2显著低于治疗前,且与对照组比较,各指标之间差异均具有统计学意义;治疗后,两组患者的WBC、CRP、PCT、IL-4、IL-6、IL-10及TNF-ɑ水平均显著低于治疗前,且试验组各炎症指标水平均显著低于对照组。结论纤支镜下肺泡灌洗术治疗老年支气管扩张并发急性重症感染的临床疗效显著,值得向临床推广。

Objective To observe the curative effect of alveolar lavage under fiberoptic bronchoscope in the treatment of bronchiectasis complicated by acute severe infection in the elderly and its influence on the related inflammatory indicators.Methods Totally 80 elderly patients with bronchiectasis complicated by acute severe infection were divided into the control group(n=40) and the experimental group(n=40). The experimental group received alveolar lavage treatment on the basis of conventional treatment, while the control group only received conventional treatment. The clinical efficacy, lung function, blood gas and inflammation indexes of the two groups of patients were compared.Results The effective rate of the experimental group was 92.5% after treatment, significantly higher than that of the control group(75.0%). After treatment, FEV1% and FEV1/FVC of both groups were significantly higher than those before treatment, and the experimental group was significantly higher than that of the control group;After treatment, SaO2, PaO2 and PaO2/FiO2 in the two groups were significantly higher than that before treatment, and PaCO2 was significantly lower than that before treatment;After treatment, two groups of patients the WBC, CRP and PCT, IL-4, IL-6, IL-10 and TNF-ɑ levels were significantly lower than before the treatment, the inflammation index levels were significantly lower than the control group and test group.Conclusion Alveolar lavage under fiberoptic bronchoscopy for the treatment of bronchiectasis complicated by acute severe infection has a significant clinical effect, and is worthy of clinical promotion.