纤维支气管镜联合乌司他丁对肺部感染致呼吸衰竭有创机械通气患者降钙素原水平和肺功能的影响

Effects of fibrobronchoscopy combined with ulinastatin on procalcitonin level and pulmonary function in patients with respiratory failure induced by pulmonary infection undergoing invasive mechanical ventilation

目的探究乌司他丁联合纤维支气管镜对肺部感染致呼吸衰竭机械通气患者降钙素原(PCT)水平和肺功能的影响。方法选取隆昌市人民医院2018年7月至2019年7月确诊为肺部感染致呼吸衰竭机械通气患者80例,按照随机数字表法分为试验组和对照组,各40例。对照组给予纤维支气管镜治疗,试验组在对照组的基础上加用乌司他丁治疗,治疗14 d后比较2组PCT等生化指标、血气分析相关指标、恢复进程及并发症发生情况。结果治疗14 d后,试验组患者血清PCT、C反应蛋白水平及PaCO_(2)均低于对照组(t值分别为27.611、10.496、6.936,P值均<0.05),PaO_(2)高于对照组(t=9.561,P<0.05);试验组患者治疗后pH值、HCO3-、碱剩余指标均优于对照组(t值分别为10.976、3.409、19.084,P值均<0.05);试验组患者呼吸衰竭纠正时间、有创通气时间、住院时间低于对照组(t值分别为3.046、3.000、3.220,P值均<0.05);试验组患者发生并发症者比例低于对照组(χ^(2)=4.501,P<0.05)。结论乌司他丁联合纤维支气管镜治疗可有效减轻肺部感染致呼吸衰竭机械通气患者炎症反应,促进恢复进程,且并发症状更少,具有推荐应用价值。

Objective To explore the effects of ulinastatin combined with fibre bronchoscopy on procalcitonin(PCT)level and pulmonary function in patients with respiratory failure induced by pulmonary infection undergoing mechanical ventilation.Methods The study involved 80 patients who were confirmed with respiratory failure induced by pulmonary infection undergoing mechanical ventilation in Longchang People's Hospital from July 2018 to July 2019.The patients were randomly divided into experimental group and control group,40 cases in each group.The control group was treated with fibrobronchoscopy,while experimental group received ulinastatin on basis of control group.After treatment for 14 days,biochemical indicators like PCT,blood gas analysis associated indexes,recovery process and occurrence of complications were compared between two groups.Results After treatment for 14 days,serum PCT,C-reactive protein and arterial partial pressure of carbon dioxide in experimental group were significantly lower than those in control group(t=27.611,10.496,6.936,all P<0.05),while arterial oxygen partial pressure was higher than that in control group(t=9.561,P<0.05).After treatment,pH,HCO_(3)-and base excess in experimental group were better than those in control group(t=10.976,3.409,19.084,all P<0.05).The correction time of respiratory failure,invasive ventilation time and hospitalization time in experimental group were shorter than those in control group(t=3.046,3.000,3.220,all P<0.05).The proportion of patients with complications in experimental group was lower than that in control group(χ^(2)=4.501,P<0.05).Conclusions Ulinastatin combined with fibrobronchoscopy can effectively alleviate inflammatory response,and promote recovery process of patients with respiratory failure induced by pulmonary infection undergoing mechanical ventilation with fewer complications.