BAL联合抗菌药物对重症肺部感染患者肺功能的影响

Effect of BAL Combined with Antibacterial Drug on Pulmonary Function in Patients with Severe Pulmonary Infection

目的:研究支气管肺泡灌洗(BAL)联合碳青霉烯类抗菌药物治疗重症肺部感染的效果。方法:选取郑州大学第一附属医院2018年4月至2019年4月收治的重症肺部感染患者88例,按照治疗方法不同分为对照组、观察组,各44例。对照组采用美罗培南治疗,观察组在对照组基础上采用BAL治疗。比较两组疗效、治疗前和治疗2周后肺功能〔第1 秒用力呼气容积(FEV1)、用力肺活量(FVC)〕、气道阻力(Raw)、血清炎症因子〔C反应蛋白(CRP)、降钙素原(PCT)〕水平及再入院率。结果:观察组患者治疗总有效率为95.45 %,高于对照组的81.82 %,差异具有统计学意义(P<0.05);治疗2周后观察组患者FEV1、FVC高于对照组,Raw低于对照组,差异具有统计学意义(P<0.05);治疗2周后观察组患者CRP、PCT均低于对照组,差异具有统计学意义(P<0.05);观察组再入院率为4.65 %,低于对照组的19.05 %,差异具有统计学意义(P<0.05)。结论:BAL联合碳青霉烯类抗菌药物治疗重症肺部感染能改善肺功能,减轻炎症反应,降低气道阻力与再入院率。

Objective To study the effect of bronchial alveolar lavage (BAL) combined with carbapenems drugs in the treatment of severe pulmonary infection.Methods 88 patients with severe pulmonary infection in The First Affiliated Hospital of Zhengzhou University from April 2018 to April 2019 were divided into control group and observation group according to treatment methods,with 44 cases in each group.The control group was treated with meropenem,and the observation group used BAL treatment based on the control group.Efficacy,lung function[force exhalation volume in one second (FEV1),force lung capacity (FVC)],airway resistance (Raw),serum inflammation factor[C reactive protein (CRP),Calcitogenic (PCT)]level and readmission rate were compared between the two groups before and 2 weeks after treatment.Results The total effective rate of in the observation group was 95.45%,which was higher than 81.82% in the control group,and the difference was statistically significant (P < 0.05);FEV1,FVC of the observation group were higher than those of the control group,and Raw was lower than that of the control group after two weeks of treatment.The differences were statistically significant (P < 0.05);CRP,PCT of the observation group were lower than those of the contral group after 2 weeks of treatment,and the difference were statistically significant (P < 0.05);The re-hospital rate of observation group is 4.65%,lower than that of the control group (19.05%),and the difference was statistically significant (P < 0.05).Conclusion BAL combined with carbapenems drugs has significant efficacy in the treatment of severe pulmonary infection,which can improve lung function,reduce inflammatory response,reduce airway resistance and readmission rate.