床旁纤维支气管镜肺泡灌洗联合抗生素对呼吸机相关性肺炎患者炎症指标的改善效果

Effect of bedside fiberoptic broncho-alveolar lavage combined with antibiotics on the improvement of inflammatory indexes in patients with ventilator-associated pneumonia

目的分析呼吸机相关性肺炎患者采用床旁纤维支气管镜肺泡灌洗联合抗生素治疗的效果以及对炎症指标的影响。方法98例呼吸机相关性肺炎患者,根据随机单盲法分为对照组及观察组,每组49例。对照组采用常规药物治疗,观察组在对照组基础上采用床旁纤维支气管镜肺泡灌洗联合抗生素治疗。比较两组退热时间、机械通气时间、重症加强护理病房(ICU)治疗时间及治疗前后炎症指标(降钙素原、C反应蛋白、白细胞介素-6)水平。结果观察组退热时间(3.6±0.8)d、机械通气时间(9.3±2.1)d、ICU治疗时间(13.2±4.3)d短于对照组的(4.3±0.9)、(10.5±2.3)、(15.2±4.7)d,差异有统计学意义(P<0.05)。治疗前,两组降钙素原、C反应蛋白、白细胞介素-6炎水平对比,差异无统计学意义(P>0.05);治疗后,观察组降钙素原、C反应蛋白、白细胞介素-6水平分别为(0.4±0.1)μg/L、(6.6±1.3)mg/L、(10.4±2.6)ng/L低于对照组的(0.6±0.3)μg/L、(12.5±2.5)mg/L、(15.2±3.2)ng/L,差异有统计学意义(P<0.05)。结论床旁纤维支气管镜肺泡灌洗联合抗生素治疗呼吸机相关性肺炎的效果显著,对患者的炎症指标改善明显,具备优势。

Objective To analyze the effect of bedside fiberoptic broncho-alveolar lavage combined with antibiotics in patients with ventilator-associated pneumonia and its influence on inflammatory indicators.Methods A total of 98 patients with ventilator-associated pneumonia were randomly divided into control group and observation group,with 49 cases in each group.The control group was treated with conventional drugs,and the observation group was treated with bedside fiberoptic broncho-alveolar lavage combined with antibiotics on the basis of the control group.The antipyretic time,mechanical ventilation time,intensive care unit(ICU)treatment time,and inflammatory indexes(procalcitonin,C-reactive protein,interleukin-6)levels before and after treatment were compared between the two groups.Results The antipyretic time(3.6±0.8)d,the mechanical ventilation time(9.3±2.1)d,and the ICU treatment time(13.2±4.3)d in the observation group were shorter than(4.3±0.9),(10.5±2.3),and(15.2±4.7)d in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of procalcitonin,C-reactive protein and interleukin-6 between the two groups(P>0.05).After treatment,the levels of procalcitonin,C-reactive protein and interleukin-6 in the observation group were(0.4±0.1)μg/L,(6.6±1.3)mg/L and(10.4±2.6)ng/L,which were lower than(0.6±0.3)μg/L,(12.5±2.5)mg/L and(15.2±3.2)ng/L in the control group,and the differences were statistically significant(P<0.05).Conclusion Bedside fiberoptic broncho-alveolar lavage combined with antibiotics is significantly effective in the treatment of ventilator-associated pneumonia,and has obvious advantages in improving the inflammatory indicators of patients.