无创呼吸机正压通气联合纤维支气管镜肺灌洗治疗COPD合并重症肺炎的临床效果研究

Clinical Effect of Noninvasive Ventilator Positive Pressure Ventilation Combined with Fiberoptic Bronchoscope Lung Lavage in the Treatment of COPD Complicated with Severe Pneumonia

目的:分析无创呼吸机正压通气联合纤维支气管镜肺灌洗治疗慢性阻塞性肺疾病(COPD)合并重症肺炎的临床效果。方法:选取2019年1月-2021年1月于本院治疗的82例COPD合并重症肺炎患者为观察对象,按照随机抽签法将其分为研究组和对照组,各41例。研究组采用无创呼吸机正压通气联合纤维支气管镜肺灌洗治疗,对照组采用无创呼吸机正压通气联合常规治疗。观察并对比两组的临床疗效和治疗前后的炎症因子表达、肺功能以及通气功能、血气分析指标。结果:治疗后,研究组总有效率为92.68%,明显高于对照组的75.61%(P<0.05)。两组患者治疗前炎症因子表达比较,差异均无统计学意义(P>0.05);治疗后,研究组HMGB1、PCT、CRP、WBC水平均显著低于对照组(P<0.05)。两组患者治疗前肺功能及通气功能比较,差异均无统计学意义(P>0.05);治疗后,研究组FVC、FEV1、FEV1/FVC%、MVV水平均显著高于对照组(P<0.05)。两组患者治疗前血气分析指标比较,差异均无统计学意义(P>0.05);治疗后,研究组PaO2、SpO2水平均显著高于对照组,PaCO2水平显著低于对照组(P<0.05)。结论:对于COPD合并重症肺炎患者,无创呼吸机正压通气联合纤维支气管镜肺灌洗治疗效果较好,可有效抑制炎症因子水平,改善肺功能、通气功能及血气分析指标,值得应用。

Objective:To analyze the clinical effect of noninvasive ventilator positive pressure ventilation combined with fiberoptic bronchoscope lung lavage in the treatment of chronic obstructive pulmonary disease(COPD)complicated with severe pneumonia.Method:A total of 82 COPD patients with severe pneumonia treated in our hospital from January 2019 to January 2021 were selected as the observation objects.According to the random drawing method,they were randomly divided into study group and control group,41 cases in each group.The study group was given noninvasive ventilator positive pressure ventilation combined with fiberoptic bronchoscope lung lavage treatment,and the control group was given noninvasive positive pressure ventilation combined with conventional treatment.The clinical efficacy,the expression of inflammatory factors,lung function,ventilation function and blood gas analysis indexes before and after treatment were observed and compared between the two groups.Result:After treatment,the total effective rate of the study group was 92.68%,which was significantly higher than 75.61%of the control group(P<0.05).There were no significant differences in the expression of inflammatory factors between the two groups before treatment(P>0.05);after treatment,the levels of HMGB1,PCT,CRP and WBC in the study group were significantly lower than those in the control group(P<0.05).There were no significant differences in pulmonary function and ventilation function between the two groups before treatment(P>0.05);after treatment,FVC,FEV;,FEV;/FVC%and MVV levels in the study group were significantly higher than those in the control group(P<0.05).There were no significant differences in blood gas analysis indexes between the two groups before treatment(P>0.05);after treatment,the levels of PaO;and SpO;in the study group were significantly higher than those in the control group,and the level of PaCO;in the study group was significantly lower than that in the control group(P<0.05).Conclusion:For COPD patients with severe pneumonia,noninvasive positive pressure ventilation combined with bronchofiberscope lung lavage has a good effect,which can effectively inhibit the level of inflammatory factors,improve lung function,ventilation function and blood gas analysis index,and is worthy of application.