纤维支气管镜肺泡灌洗对重症肺炎机械通气患儿呼吸功能及炎症指标的影响

Effects of Alveolar Lavage with Fiberoptic Bronchoscope on Respiratory Function and Inflammatory Indexes in Children with Severe Pneumonia Undergoing Mechanical Ventilation

目的:探讨纤维支气管镜肺泡灌洗对重症肺炎机械通气患儿呼吸功能及炎症指标的影响。方法:选取2019年12月-2020年12月本院接受治疗的100例重症肺炎机械通气患儿,依据双盲法分为观察组(50例)与对照组(50例)。观察组予以重症肺炎常规治疗+纤维支气管镜肺泡灌洗治疗,对照组予以单独重症肺炎常规治疗,两组均连续治疗7 d。对比两组治疗前、治疗7 d后呼吸功能[氧合指数(OI)、血氧饱和度(SaO_(2))]与炎症指标[C反应蛋白(CRP)、高迁移率族蛋白B1(HMGB-1)、可溶性髓系细胞发受体-1(sTREM-1)]水平。结果:两组治疗前OI与SaO_(2)比较,差异均无统计学意义(P>0.05);治疗7 d后,两组OI、SaO_(2)水平较治疗前上升,且观察组OI、SaO_(2)水平均高于对照组(P<0.05)。两组治疗前CRP、HMGB-1及sTREM-1水平比较,差异均无统计学意义(P>0.05);治疗7 d后,两组CRP、HMGB-1及sTREM-1水平均较治疗前下降,且观察组CRP、HMGB-1及sTREM-1水平低于对照组,差异有统计学意义(P<0.05)。结论:重症肺炎机械通气患儿采用纤维支气管镜肺泡灌洗治疗效果确切,可有效改善患儿呼吸功能,降低炎症因子水平,值得临床推广。

Objective:To investigate the effect of alveolar lavage with fiberoptic bronchoscope on respiratory function and inflammatory indexes in children with severe pneumonia undergoing mechanical ventilation.Method:From December 2019 to December 2020,100 children with severe pneumonia undergoing mechanical ventilation treated in our hospital were selected and divided into observation group (50 cases) and control group (50 cases) according to double-blind method.The observation group was treated with routine treatment of severe pneumonia and alveolar lavage with fiberoptic bronchoscope,while the control group was treated with routine treatment of severe pneumonia alone,the two groups were treated for 7 days.The respiratory function[oxygenation index (OI),blood oxygen saturation (SaO_(2))]and inflammatory indexes[C-reactive protein (CRP),high mobility group protein B1 (HMGB-1),soluble myeloid cell receptor-1 (sTREM-1)]levels were compared between the two groups before and 7 days after treatment.Result:There were no significant differences in OI and SaO_(2)between the two groups before treatment (P>0.05);after 7 days of treatment,OI and SaO_(2)of the two groups increased compared with before treatment,and OI and SaO_(2)of the observation group were higher than those of the control group (P<0.05).There were no significant differences in the levels of CRP,HMGB-1 and sTREM-1 between the two groups before treatment (P>0.05);after 7 days of treatment,the levels of CRP,HMGB-1 and sTREM-1 in the two groups declined compared with before treatment,and the levels of CRP,HMGB-1 and sTREM-1 in the observation group were lower than those in the control group (P<0.05).Conclusion:Alveolar lavage with fiberoptic bronchoscope is effective in the treatment of severe pneumonia in children with mechanical ventilation,which can effectively improve the respiratory function of children and reduce the level of inflammatory factors,which is worthy of clinical promotion.