纤维支气管镜肺泡灌洗对老年支气管扩张合并感染的治疗效果探讨

Discussion on effect of bronchoalveolar lavage on the treatment of bronchiectasis with infection in the elderly

目的观察老年支气管扩张合并感染患者采用纤维支气管镜肺泡灌洗治疗的效果。方法74例老年支气管扩张合并感染患者,随机分为对照组和观察组,每组37例。对照组给予常规治疗,观察组在对照组基础上采用纤维支气管镜肺泡灌洗治疗。比较两组患者临床疗效,临床症状体征缓解时间,治疗前后血气指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、氧合指数(PaO_(2)/FiO_(2))]。结果治疗后,观察组患者的治疗总有效率为94.59%(35/37),显著高于对照组的72.97%(27/37),差异有统计学意义(χ^(2)=6.366,P<0.05)。观察组患者的发热缓解时间为(4.07±1.28)d,咳嗽咳痰缓解时间为(6.85±2.04)d,肺部湿啰音消失时间为(6.93±2.11)d,均显著短于对照组的(5.73±1.84)、(10.23±4.31)、(9.95±3.67)d,差异具有统计学意义(P<0.05)。治疗前,两组患者的PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平比较差异无统计学意义(P>0.05);治疗后,两组患者的PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平均高于本组治疗前,观察组患者的PaO_(2)(88.23±8.67)mm Hg(1 mm Hg=0.133 kPa)、SaO_(2)(92.41±5.06)%、PaO_(2)/FiO_(2)(326.84±26.95)mm Hg均高于对照组的(80.33±7.19)mm Hg、(87.23±4.15)%、(288.70±21.34)mm Hg,差异具有统计学意义(P<0.05)。结论纤维支气管肺泡灌洗治疗支气管扩张并感染患者的疗效可靠,可加速患者症状缓解,对患者血气指标水平改善明显,值得推广。

Objective To observe the effect of bronchoalveolar lavage on the treatment of bronchiectasis with infection in the elderly.Methods A total of 74 elderly patients with bronchiectasis and infection were randomly divided into control group and observation group,with 37 cases in each group.The control group received conventional treatment,and the observation group received bronchoalveolar lavage on the basis of the control group.Both groups were compared in terms of clinical efficacy,remission time of clinical symptoms and signs,and blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2))and oxygenation index(PaO_(2)/FiO_(2))]before and after treatment.Results After treatment,the total effective rate of 94.59%(35/37)in the observation group was significantly higher than that of 72.97%(27/37)in the control group,and the difference was statistically significant(χ^(2)=6.366,P<0.05).In the observation group,the remission time of fever was(4.07±1.28)d,the remission time of cough and sputum was(6.85±2.04)d,and the disappearance time of lung moist rale was(6.93±2.11)d,which were significantly shorter than those of(5.73±1.84),(10.23±4.31),and(9.95±3.67)d in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in PaO_(2),SaO_(2)and PaO_(2)/FiO_(2)levels between the two groups(P>0.05).After treatment,the levels of PaO_(2),SaO_(2)and PaO_(2)/FiO_(2)in both groups were higher than those before treatment in this group;the observation group had PaO_(2)of(88.23±8.67)mm Hg(1 mm Hg=0.133 kPa),SaO_(2)of(92.41±5.06)%and PaO_(2)/FiO_(2)of(326.84±26.95)mm Hg,which were higher than those of(80.33±7.19)mm Hg,(87.23±4.15)%and(288.70±21.34)mm Hg in the control group;the differences were statistically significant(P<0.05).Conclusion Bronchoalveolar lavage is reliable on the treatment of bronchiectasis with infection in the elderly,which can accelerate the remission of symptoms,improve the blood gas index level of patients significantly,and is worth promoting.