支气管肺泡灌洗辅助无创通气治疗重症肺炎合并呼吸衰竭的疗效

Effect of bronchoalveolar lavage combined with noninvasive ventilation under fiberoptic bronchoscope on arterial blood gas,lung function and inflammatory factors in patients with severe pneumonia complicated with respiratory failure

目的观察纤维支气管镜下支气管肺泡灌洗(BAL)联合无创通气(NIPPV)对重症肺炎合并呼吸衰竭患者动脉血气、肺功能及炎症因子的影响。方法选择浙江省永康市第一人民医院2019年3月-2020年5月收治的74例重症肺炎合并呼吸衰竭患者按照随机数表法分为两组,每组37例。对照组采用单独NIPPV治疗,研究组采用BAL联合NIPPV治疗。比较两组治疗前后动脉血气、肺功能及炎症因子的变化情况,并评估两组临床疗效。结果治疗后,两组PaCO_(2)、血清IL-6、CRP、PCT水平均下降,而PaO_(2)、SaO_(2)、FVC、FEV1、PEF均上升,且研究组上述指标改善情况均优于对照组,差异有统计学意义(P<0.05);研究组总有效率(97.30%)较对照组(78.38%)高,差异有统计学意义(P<0.05)。结论给予重症肺炎合并呼吸衰竭患者BAL联合NIPPV治疗,可有效提升治疗效果,改善动脉血气,减轻炎症反应,促进肺功能恢复,具有临床推广意义。

Objective To observe the effect of fiberoptic bronchoscopic bronchoalveolar lavage(BAL)combined with non-invasive ventilation(NIPPV)on arterial blood gas,lung function and inflammatory factors in patients with severe pneumonia complicated with respiratory failure.Methods Select 74 patients with severe pneumonia and respiratory failure admitted from the First Peoples Hospital of Yongkang city,Zhejiang province from March 2019 to May 2020.They were divided into two groups according to the random number table method,with 37 cases in each group.The control group was treated with NIPPV alone,and the study group was treated with BAL combined with NIPPV.The changes of arterial blood gas,lung function and inflammatory factors before and after treatment were compared between the two groups,and the clinical efficacy of the two groups was evaluated.Results After treatment,the two groups of PaCO_(2),serum IL-6、CRP、PCT levels decreased,while PaO_(2)、SaO_(2)、FVC、FEV1、PEF increased,and the improvement of the above indicators in the study group was better than the control group,the difference was statistically significant(P<0.05);the total effective rate of the study group(97.30%)was higher than that of the control group(78.38%),and the difference was statistically significant(P<0.05).Conclusion BAL combined with NIPPV treatment for patients with severe pneumonia combined with respiratory failure can effectively enhance the therapeutic effect,improve arterial blood gas,reduce inflammation,and promote the recovery of lung function,which has clinical significance.