保护性支气管肺泡灌洗在成人重症肺炎治疗中的应用研究

Application of protective bronchoalveolar lavage in treatment of severe pneumonia in adults

目的探讨保护性支气管肺泡灌洗在成人重症肺炎治疗中的临床应用效果。方法选取2018年2月—2020年2月安阳市人民医院收治的成人重症肺炎患者110例,根据治疗方法随机分为研究组和对照组各55例。应用非灌洗气管内吸痰治疗的55例患者设为对照组,应用保护性支气管肺泡灌洗治疗的55例患者设为研究组,比较两组患者临床疗效,对比分析两组患者退热时间、住重症监护室时间及机械通气时间,并观察记录灌洗前后两组患者氧合指数(OI)、气道阻力(RAW)及气道峰压(PIP)变化情况。结果与对照组总有效率(69.09%)比较,研究组总有效率显著增高(87.27%),研究组退热时间、住重症监护室时间及机械通气时间均显著减少(P<0.05);与灌洗前1 h比较,灌洗后6 h及24 h两组OI显著增高,RAW及PIP均显著降低(P<0.05);与灌洗后6 h比较,灌洗后24 h两组OI显著增高,RAW及PIP均显著降低(P<0.05);与对照组比较,灌洗后6 h及24 h研究组OI显著增高,RAW及PIP均显著降低(P<0.05)。结论成人重症肺炎治疗中应用保护性支气管肺泡灌洗临床效果显著,不仅可缩短患者转归时间,还能有效改善患者OI,降低RAW及PIP。

Objective To investigate the clinical effect of protective bronchoalveolar lavage in the treatment of severe pneumonia in adults.Methods A total of 110 adult patients with severe pneumonia admitted to anyang people’s hospital from February 2018 to February 2020 were selected. The control group received non-lavage endotracheal sputum aspiration, and the research group received protective bronchoalveolar lavage. The clinical efficacy of the two groups of patients was compared, and the time of fever reduction, admission to intensive care unit and mechanical ventilation of the two groups were compared and analyzed. The changes of OI, RAW and PIP were observed and recorded before and after lavage.Results Compared with the control group(69.09%), the total effective rate of the study group was significantly increased(87.27%), and the antipyretic time, icu stay time and mechanical ventilation time of the study group were significantly decreased(P<0.05). Compared with 1 h before lavage, 6 h and 24 h after lavage, OI increased significantly and RAW and PIP decreased significantly(P<0.05). Compared with 6 h after lavage, OI was significantly increased and RAW and PIP significantly decreased in both groups 24 h after lavage(P<0.05). Compared with the control group, 6 h and 24 h after lavage, the groups had significantly higher OI and significantly lower RAW and PIP(P<0.05).Conclusion The application of protective bronchoalveolar lavage in the treatment of severe pneumonia in adults has a significant clinical effect. It can not only shorten the patient’s transition time, but also effectively improve patients’ OI, reduce RAW and PIP, which is worthy of promotion.