胸腺法新联合纤维支气管镜肺泡灌洗治疗重症肺炎合并呼吸衰竭的效果

Effect of Thymosin Combined with Fiberoptic Bronchoscope Alveolar Lavage in the Treatment of Severe Pneumonia Complicated with Respiratory Failure

目的 探讨胸腺法新联合纤维支气管镜肺泡灌洗治疗重症肺炎合并呼吸衰竭患者的效果。方法 选取2019年2月—2020年10月收治的重症肺炎合并呼吸衰竭97例,据治疗方法不同分为观察组49例和对照组48例。对照组予基础治疗联合纤维支气管镜肺泡灌洗,观察组在对照组基础上加用胸腺法新治疗。比较2组疗效,治疗前后血气分析指标[动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))及PaO_(2)/吸入氧浓度(FiO_(2))],肺功能指标[用力肺活量(FVC)、第1秒用力呼气量(FEV1)、呼气流量峰值(PEF)、第1秒用力呼气量占用力肺活量比值(FEV1/FVC)],炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、降钙素原(PCT)、C反应蛋白(CRP)],免疫功能指标[CD3+、CD4+、CD8+、CD4+/CD8+],以及不良反应情况。结果 观察组总有效率高于对照组(P<0.05)。治疗后2组PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)、FVC、FEV1、PEF、FEV1/FVC、CD3+、CD4+及CD4+/CD8+升高,PaCO_(2)、TNF-α、PCT、CRP、IL-8及CD8+降低,且观察组上述指标升高及降低程度大于对照组(P<0.05,P<0.01)。2组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论 胸腺法新联合纤维支气管镜肺泡灌洗治疗可提高重症肺炎合并呼吸衰竭患者疗效,改善血气分析指标及肺功能,有效抑制炎症反应,提高机体免疫功能,且安全性良好。

Objective To investigate the effect of Thymosin combined with fiberoptic bronchoalveolar lavage in the treatment of severe pneumonia complicated with respiratory failure.Methods A total of 97 patients with severe pneumonia complicated with respiratory failure who were admitted to our hospital from February 2019 to October 2020 were selected,and they were divided into the observation group(n=49)and the control group(n=48)according to different treatment methods.The control group was given basic treatment combined with bronchoalveolar lavage with fiberoptic bronchoscopy,and the observation group was given Thymosin on the basis of the control group.The curative effects of the two groups were compared,and blood gas analysis indexes before and after treatment[arterial partial pressure of oxygen(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)),blood oxygen saturation(SaO_(2))and PaO_(2)/inhaled oxygen concentration(FiO_(2))],pulmonary function indexes[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),procalcitonin(PCT),C-reactive protein(CRP)],immune function indicators[CD3+,CD4+,CD8+,CD4+/CD8+],and adverse reactions were compared.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,PaO_(2),SaO_(2),PaO_(2)/FiO_(2),FVC,FEV1,PEF,FEV1/FVC,CD3+,CD4+and CD4+/CD8+in the two groups increased,while PaCO_(2),TNF-α,PCT,CRP,IL-8 and CD8+decreased;the increase and the decrease of the above indicators in the observation group were greater than those in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Thymosin combined with bronchoalveolar lavage with fiberoptic bronchoscopy can improve the curative effect of patients with severe pneumonia complicated with respiratory failure,improve blood gas analysis indicators and pulmonary function,effectively inhibit the degree of inflammatory response,and improve the body's immune function,with good safety.