纤维支气管镜肺泡灌洗治疗重症肺炎合并呼吸衰竭的临床价值

The Clinical Value of Fiberoptic Bronchoscope Alveolar Lavage in the Treatment of Severe Pneumonia with Respiratory Failure

目的:探讨重症肺炎合并呼吸衰竭采用纤维支气管镜肺泡灌洗治疗的临床价值。方法:将本院2018年8月-2020年7月收治的68例重症肺炎合并呼衰患者按治疗方法分为对照组和观察组,对照组32例,采用常规治疗,观察组36例,在常规治疗基础上给予纤维支气管镜肺泡灌洗治疗,对比两组治疗前后的肺功能改善情况、血气指标、氧合指数及炎症反应。结果:两组治疗期间均未出现严重不良反应,与对照组比较,观察组治疗后呼气流量峰值(PEF)、第一秒用力呼气容积(FEV_(1))、第一秒用力呼气量占用力肺活量比值(FEV_(1)/FVC)、动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、氧合指数(PaO_(2)/FiO_(2))明显较高,动脉血二氧化碳分压(PaCO_(2))、C反应蛋白(CRP)、降钙素原(PCT)、中性粒细胞百分比明显较低,差异均有统计学意义(P<0.05)。结论:纤维支气管镜肺泡灌洗治疗重症肺炎合并呼吸衰竭,可明显提高肺部呼吸功能,改善血气指标,降低炎症反应,安全性较高。

Objective:To explore the clinical value of fiberoptic bronchoscope alveolar lavage in the treatment of severe pneumonia with respiratory failure.Method:Sixty-eight patients with severe pneumonia complicated with respiratory failure who admitted in our hospital from August 2018 to July 2020 were selected and divided into the control group and the observation group by treatment method.The control group (n=32) received conventional treatment,and the observation group (n=36) received fiberoptic bronchoscope alveolar lavage on the basis of the control group.The improvement of lung function,blood gas index,oxygenation index and inflammatory reaction of the two groups before and after treatment were compared.Result:No serious adverse reactions occurred in the two groups during the treatment.After treatment,the peak expiratory flow (PEF),forced expiratory volume (FEV_(1)) in the first second,forced expiratory volume in the first second to force vital capacity ratio (FEV_(1)/FVC),arterial oxygen partial pressure (PaO_(2)),blood oxygen saturation (SaO_(2)),and oxygenation index (PaO_(2)/FiO_(2)) in the observation group were significantly higher than those in the control group (P<0.05),arterial carbon dioxide partial pressure (PaCO_(2)),C-reactive protein (CRP),procalcitonin (PCT),and the percentage of neutrophils in the observation group were significantly lower than those in the control group (P<0.05).Conclusion:Fiberoptic bronchoscope alveolar lavage in the treatment of severe pneumonia with respiratory failure can significantly improve lung respiratory function,improve blood gas indicators,reduce inflammation reaction,and has high safety.