床旁纤维支气管镜肺泡灌洗结合全面护理对重症肺部感染患者体征、动脉血气分析指标的影响

Effect of Bedside Bronchoscopy Alveolar Lavage Combined with Comprehensive Nursing on Signs and Arterial Blood Gas Analysis Indexes of Patients with Severe Pulmonary Infection

目的:分析床旁纤维支气管镜肺泡灌洗结合全面护理对重症肺部感染患者体征、动脉血气分析指标的影响。方法:选取2017年1月—2020年5月商丘市第一人民医院收治的82例重症肺部感染患者作为研究对象,按随机数表法分为实验组和对照组,每组各41例,对照组予以头孢哌酮钠舒巴坦钠联合全面护理,实验组在对照组的基础上予以床旁纤维支气管镜肺泡灌洗结合全面护理。对比两组患者的疗效、症状表现相关时间与住院时间及干预前后患者体征[心率(HR)、平均动脉压 (MAP)]、动脉血气分析指标 [动脉血氧饱和度 (SaO)、动脉血氧分压 (PaO)、动脉二氧化碳分压 (PaCO)]、炎性因子 [C反应蛋白 (CRP)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)] 水平变化。结果:实验组总有效率较对照组高,差异有统计学意义 (χ^(2)=4.100,P<0.05);实验组肺部炎症吸收时间、血象恢复正常、体温恢复正常、住院时间较对照组短,差异有统计学意义 (t=4.955、6.608、5.194、5.450,P<0.05);干预后,实验组 HR、MAP 水平较对照组低,差异有统计学意义 (t=3.390、7.104,P<0.05);干预后,实验组 SaO、PaO水平较对照组高,PaCO水平较对照组低,差异有统计学意义 (t=2.889、5.391、11.061,P<0.05);干预后,实验组CRP、IL-6、TNF-α水平较对照组低,差异有统计学意义 (t=8.518、6.681、4.971,P<0.05)。结论:床旁纤维支气管镜肺泡灌洗结合全面护理应用于重症肺部感染患者中,可提高疗效,加快症状恢复,改善患者体征和血气指标,还可促进炎性物质吸收,降低炎性因子水平。

Objective: To analyze the influence of bedside bronchoscopy alveolar lavage combined with comprehensive nursing on the signs and arterial blood gas analysis indexes of patients with severe pulmonary infection. Methods: A total of 82 patients with severe pulmonary infection admitted to the hospital from January 2017 to May 2020 were selected and divided into experimental group and control group according to the random number table method, with 41 cases in each group. The control group received cefoperazone sodium and sulbactam sodium combined with comprehensive nursing, while the experimental group received bedside fiberoptic bronchoscopy bronchoalveolar lavage combined with comprehensive nursing on the basis of the control group. The curative effect, symptom related time and hospitalization time, patient signs before and after intervention (heart rate [HR], mean arterial pressure [MAP]), arterial blood gas analysis indicators (arterial oxygen saturation [SaO], arterial blood oxygen partial pressure][PaO], arterial partial pressure of carbon dioxide [PaCO]) and inflammatory factors (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]) levels were compared between the two groups. Results: The total effective rate of the experimental group was higher than that of the control group, and the difference was statistically significant (χ^(2)=4.100, P<0.05). The absorption time of pulmonary inflammation, blood picture returned to normal, body temperature returned to normal, and hospitalization time was shorter in the experimental group than in the control group, and the differences were statistically significant (t=4.9556.608, 5.194, 5.450, P<0.05). After the intervention, the HR and MAP levels in the experimental group were lower than those in the control group, and the difference was statistically significant (t=3.390, 7.104, P<0.05). After the intervention, the levels of SaOand PaOin the experimental group were higher than those in the control group, and the level of PaCOwas lower than that in the control group, and the differences were statistically significant (t=2.889, 5.391, 11.061, P<0.05). After intervention, the levels of CRP, IL-6 and TNF-α in the experimental group were lower than those in the control group, and the difference was statistically significant (t=8.518, 6.681, 4.971, P<0.05). Conclusion: Bedside fiberoptic bronchoalveolar lavage combined with comprehensive nursing care in patients with severe pulmonary infection can improve the curative effect, accelerate symptom recovery, improve patient signs and blood gas indicators, and also promote the absorption of inflammatory substances and reduce the level of inflammatory factors.