乙酰半胱氨酸溶液肺泡灌洗治疗支气管扩张急性加重期患者的临床效果

Clinical effect of alveolar lavage combined with acetylcysteine solution on patients with acute exacerbation of bronchiectasis

目的 探讨经支气管镜肺泡灌洗治疗并注入乙酰半胱氨酸溶液在支气管扩张急性加重期患者中的临床疗效。方法 选取2022年1—11月于山东省第二人民医院呼吸与危重症医学科住院并确诊为支气管扩张急性加重期的患者60例,随机分为对照组(30例)和观察组(30例)。对照组给予氧疗、抗感染、祛痰常规治疗,观察组在常规治疗基础上给予支气管镜肺泡灌洗治疗并注入乙酰半胱氨酸溶液。比较两组患者临床疗效、治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)]、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)]、住院时间及并发症情况。结果 观察组总有效率高于对照组(P<0.05);治疗后两组患者血气指标、炎症指标、肺功能指标较治疗前均有改善,且观察组WBC、CRP、PCT、IL-6、PaCO_(2)均低于对照组,观察组FEV_(1)、FVC、PaO_(2)均高于对照组,差异有统计学意义(P<0.05);观察组住院时间短于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 经支气管镜肺泡灌洗治疗并注入乙酰半胱氨酸溶液可有效改善支气管扩张症患者的症状及血气指标、炎症指标及肺功能,缩短住院时间,值得临床应用。

Objective To explore the clinical effect of bronchoalveolar lavage combined with injection of acetylcysteine solution in patients with acute exacerbation of bronchiectasis.Methods A total of 60 patients who were hospitalized in the Department of Respiratory and Critical Care Medicine of the Shandong Second Provincial General Hospital from January to November 2022 and diagnosed with acute exacerbation of bronchiectasis were randomly divided into the control group(30 patients)and the observation group(30 patients).The control group was given oxygen therapy,anti-infection treatment and expectorant treatment,while the observation group was given bronchoalveolar lavage combined with injection of acetylcysteine solution based on routine treatment.The clinical efficacy,the blood gas indexes(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)]),inflammatory indexes(white blood cells count[WBC],C-reactive protein[CRP],procalcitonin[PCT],interleukin-6[IL-6])and pulmonary function indexes(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC])before and after treatment,the hospital stay and the incidence of complications were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The blood gas indexes,inflammatory indexes and pulmonary function indexes of the two groups after treatment were better than those before treatment.And the WBC,CRP,PCT,IL-6,and PaCO_(2) in the observation group were lower than those in the control group,while the FEV_(1),FVC,and PaO_(2) in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The hospital stay in the observation group was shorter than that in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Bronchoalveolar lavage combined with injection of acetylcysteine solution can effectively improve the symptoms,blood gas indexes,inflammatory indexes,and lung function indexes of patients with bronchiectasis,shorten the hospital stay.Therefore,it is worthy of clinical application.