纤维支气管镜介入治疗重症呼吸机相关性肺炎的临床疗效及其对炎性因子与呼吸力学指标的影响

Clinical effect of interventional treatment of severe ventilator-associated pneumonia with fiberoptic bronchoscopy and its influence on inflammatory factors and respiratory mechanics indexes

目的探讨纤维支气管镜介入治疗重症呼吸机相关性肺炎的临床疗效及其对炎性因子与呼吸力学指标的影响。方法选取汕头市中心医院2018年1月—2020年1月收治的重症呼吸机相关性肺炎患者120例,随机分为对照组与研究组,各60例。对照组给予常规治疗,研究组给予纤维支气管镜介入治疗。比较2组临床疗效,治疗前后白介素6(IL-6)、白介素8(IL-8)、降钙素(PCT)、气道峰压(PIP)、动态顺应性(Cdyn)、呼吸做功(WOB)、气道阻力(Raw),并比较2组并发症发生率。结果研究组总有效率高于对照组(P<0.05)。治疗前2组IL-6、IL-8、PCT比较,差异无统计学意义(P>0.05);治疗后研究组IL-6、IL-8、PCT低于对照组(P<0.05)。治疗前2组PIP、Cdyn、WOB、Raw比较,差异无统计学意义(P>0.05);治疗后研究组PIP、WOB、Raw低于对照组,Cdyn高于对照组(P<0.05)。2组均未发生并发症。结论纤维支气管镜介入治疗重症呼吸机相关性肺炎的临床疗效确切,能有效改善患者炎性因子水平以及呼吸力学指标,且安全性较高。

Objective To investigate the clinical efficacy of fiberoptic bronchoscopy in the treatment of severe ventilator-associated pneumonia and its influence on inflammatory factors and respiratory mechanics.Methods A total of 120 cases of patients with severe ventilator-related pneumonia were selected from January 2018 to January 2020 in Shantou Central Hospital,which were divided into control group and research group,60 cases respectively.The control group was given routine treatment,and the research group was treated with fibrobronchoscopy.The clinical efficacy of the two groups was compared.The incidence of complications in the two groups was compared,including IL-6,IL-8,PCT,PIP,Cdyn,WOB and Raw.Results The total effective rate of the study group was higher than that of the control group(P<0.05).There was no significant difference in IL-6,IL-8 and PCT between the two groups before treatment(P>0.05);after treatment,the IL-6,IL-8 and PCT in the study group were lower than that in the control group(P<0.05).There was no significant difference in PIP,Cdyn,WOB and Raw between the two groups before treatment(P>0.05);after treatment,the PIP,WOB and Raw in the study group were lower than that in the control group,and Cdyn was higher than that of the control group(P<0.05).No complications occurred in both groups.Conclusion The clinical effect of fiberoptic bronchoscopy in the treatment of severe ventilatorassociated pneumonia is exact,which can effectively improve the level of inflammatory factors and respiratory mechanics indexes,and with high safety.