支气管肺泡灌洗联合无创正压通气在重症肺炎合并Ⅱ型呼吸衰竭患者中的应用研究

Effect of Bronchoalveolar Lavage Combined with NIPPV in Patients with Severe Pneumonia Complicated with typeⅡRespiratory Failure

目的 探讨支气管肺泡灌洗(BAL)联合无创正压通气(NIPPV)在重症肺炎合并Ⅱ型呼吸衰竭患者中的应用效果。方法 选择本院2019年6月至2021年9月收治的128例重症肺炎合并Ⅱ型呼吸衰竭患者,按随机数表法分为两组,各64例。对照组行NIPPV治疗,治疗组行BAL联合NIPPV治疗。对比两组炎症反应(IL-6与CRP)、健康状况、血气分析指标(SaO_(2)、PaCO_(2)与PaO_(2))、ICU入住时间与有创机械通气率。结果 治疗后两组IL-6、CRP、APACHEⅡ均低于治疗前,治疗组降低幅度较对照组大,有统计学差异(P<0.05);治疗后两组SaO_(2)、PaO_(2)均高于治疗前,PaCO_(2)低于治疗前,治疗组降低或升高幅度较对照组大,差异有统计学意义(P<0.05);治疗组ICU入住时间为(8.42±2.66)d,短于对照组的(13.88±4.12)d,差异有统计学意义(P<0.05);治疗组有创机械通气率为5.88%,低于对照组的27.94%,差异有统计学意义(P<0.05)。结论 重症肺炎合并Ⅱ型呼吸衰竭行BAL联合NIPPV治疗可减轻炎症反应,改善血气分析指标,降低有创机械通气率,缩短ICU入住时间,减轻病情严重程度。

Objective To investigate the application effect of bronchoalveolar lavage(BAL)combined with non-invasive positive pressure ventilation(NIPPV)in patients with severe pneumonia complicated with typeⅡrespiratory failure.Methods 128patients with severe pneumonia complicated with typeⅡrespiratory failure admitted to our hospital from June 2019to September 2021were selected and divided into two groups according to the random number table method.in the control group were treated with NIPPV,and in the treatment group were treated with BAL combined with NIPPV.The inflammatory response(IL-6and CRP),health status(blood gas analysis indicators SaO_(2),PaCO_(2)and PaO_(2)and ICU admission were compared between the two groups Inter-invasive mechanical ventilation rate.Results After treatment,the levels of IL-6,CRP and APACHEⅡin the two groups were lower than those before treatment,and the decrease in the treatment group was greater than that in the control group,with statistical differences(P<0.05).After treatment,SaO_(2)and PaO_(2)of the two groups were higher than those before treatment,and PaCO_(2)was lower than that before treatment.The decrease or increase of the treatment group was larger than that of the control group,with statistical differences(P<0.05).The ICU stay time of the treatment group was(8.42±2.66)d,which was shorter than that of the control group(13.88±4.12)d,and the difference was statistically significant(P<0.05).The invasive mechanical ventilation rate in the treatment group was 5.88%,which was lower than 27.94%in the control group,and the difference was statistically significant(P<0.05).Conclusion BAL combined with NIPPV can reduce inflammation,improve blood gas analysis index,reduce invasive mechanical ventilation rate,shorten ICU stay time,and reduce the severity of severe pneumonia complicated with typeⅡrespiratory failure.