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纤维支气管镜肺灌洗+BiPAP呼吸机对AECOPD合并Ⅱ型呼吸衰竭患者肺功能及动脉血气指标改善的影响 被引量:6

Effect of fiberoptic bronchoscope lung lavage+BiPAP ventilator on the improvement of pulmonary function and arterial blood gas indexes in patients with AECOPD and typeⅡrespiratory failure
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摘要 目的:探究纤维支气管镜肺灌洗+双水平无创正压机械通气(BiPAP)呼吸机对慢阻肺急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者肺功能及动脉血气指标改善的影响。方法:选取2018年12月~2019年12月本院收治的AECOPD合并Ⅱ型呼吸衰竭患者86例,随机数字表分为呼吸机组(n=43)、联合组(n=43)。呼吸机组给予BiPAP呼吸机治疗,联合组给予纤维支气管镜肺灌洗+BiPAP呼吸机治疗。比较两组的疗效及治疗前后肺功能指标[第1秒呼气量(FEV1)、用力肺活量(FVC)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清炎症因子[S100A8/A9、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)]水平。结果:联合组总有效率高于呼吸机组(P<0.05);治疗2周后联合组PaO_(2)高于呼吸机组,PaCO_(2)低于呼吸机组(P<0.05);治疗2周后联合组FEV1、FVC高于呼吸机组(P<0.05);治疗2周后联合组血清S100A8/A9、TNF-α、CRP水平低于呼吸机组(P<0.05)。结论:纤维支气管镜肺灌洗+BiPAP呼吸机治疗AECOPD合并Ⅱ型呼吸衰竭患者,可降低血清S100A8/A9、TNF-α、CRP水平,改善肺功能及动脉血气指标,疗效显著。 Objective:To explore the effect of fiberoptic bronchoscopy lung lavage+bilevel non-invasive positive pressure mechanical ventilation(BiPAP)ventilator on the improvement of lung function and arterial blood gas indexes in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and type Ⅱ respiratory failure.Methods:A total of 86 patients with AECOPD combined with type Ⅱ respiratory failure admitted to our hospital from December 2018 to December 2019 were selected.The random number table was divided into a breathing unit(n=43)and a combined group(n=43).The breathing unit was treated with BiPAP ventilator,and the combined group was treated with fiberoptic bronchoscope lung lavage+BiPAP ventilator.The efficacy and lung function indexes before and after treatment were compared between the two groups[expiratory volume in 1 second(FEV1),forced vital capacity(FVC)],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],Serum inflammatory factors[S100A8/A9,tumor necrosis factorα(TNF-α),C-reactive protein(CRP)]levels.Results:The total effective rate of the combined group was higher than that of the breathing machine unit(P<0.05);PaO_(2) of the combined group was higher than that of the breathing machine unit and PaCO_(2) was lower than that of the breathing machine group after 2 weeks of treatment(P<0.05);FEV1 and FVC of the combined group were higher than that of the combined group after 2 weeks of treatment Breathing machine(P<0.05);After 2 weeks of treatment,the serum S100A8/A9,TNF-α,CRP levels in the combined group were lower than those of the breathing machine(P<0.05).Conclusion:Fibrobronchoscope lung lavage+BiPAP ventilator can reduce serum S100A8/A9,TNF-α,CRP levels in patients with AECOPD combined with typeⅡrespiratory failure,and improve lung function and arterial blood gas indexes.The effect is significant.
作者 华国操 HUA Guocao(Maoming City People's Hospital of Guangdong Province,Maoming,Guangdong 525000)
出处 《包头医学院学报》 CAS 2022年第4期33-36,共4页 Journal of Baotou Medical College
关键词 慢阻肺急性加重期 肺灌洗 机械通气 呼吸衰竭 动脉血气指标 acute exacerbation of chronic obstructive pulmonary disease lung lavage positive pressure mechanical ventilation respiratory failure arterial blood gas index
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