纤维支气管镜肺泡灌洗联合美罗培南治疗ICU重症肺炎患者的效果

Effects of fiberoptic bronchoscopy alveolar lavage combined with Meropenem in treatment of ICU patients with severe pneumonia

目的:观察纤维支气管镜肺泡灌洗联合美罗培南治疗重症医学监护室(ICU)重症肺炎患者的效果。方法:选取2021年5月至2023年5月该院收治的80例重症肺炎患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组40例。对照组给予美罗培南治疗,观察组在对照组基础上联合纤维支气管镜肺泡灌洗治疗。比较两组临床疗效,临床症状缓解时间,住ICU时间,治疗前后动脉血气指标[氧合指数(OI)、动脉血氧分压(PaO_(2))]水平、炎性因子[皮质醇(Cor)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)]水平,以及不良反应发生率。结果:观察组治疗总有效率为95.00%(38/40),高于对照组的75.00%(30/40),差异有统计学意义(P<0.05);观察组咳嗽、呼吸困难、肺啰音、发热等临床症状缓解时间和住ICU时间均短于对照组,差异有统计意义(P<0.05);治疗后,两组OI、PaO_(2)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组Cor、IL-4、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:纤维支气管镜肺泡灌洗联合美罗培南治疗ICU重症肺炎患者,可提高临床疗效,促进临床症状缓解,缩短住ICU时间,改善动脉血气指标水平,减轻机体炎症反应,效果优于单纯美罗培南治疗。

Objective:To observe effects offiberoptic bronchoscopy alveolar lavage combined with Meropenem in treatment of patients with severe pneumonia in intensive care unit(ICU).Methods:A prospective study was conducted on 80 patients with severe pneumonia admitted to the hospital from May 2021 to May 2023.According to the random number table method,they were divided into control group and observation group,40 cases in each group.The control group was treated with Meropenem,while the observation group was treated withfiberoptic bronchoscopy alveolar lavage on the basis of that of the control group.The clinical efficacy,the clinical symptom relief time and the ICU stay time,the arterial blood gas indexes[oxygenation index(OI),arterial partial pressure of oxygen(PaO_(2))]levels and the inflammatory factors[cortisol(Cor),interleukin-4(IL-4),interleukin-6(IL-6)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 95.00%(38/40),which was higher than 75.00%(30/40)of the control group,and the difference was statistically significant(P<0.05).The cough,dyspnea,lung rale disappearance time,the body temperature recovery time and the ICU stay time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of OI and PaO_(2)in the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of Cor,IL-4 and IL-6 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Fiberoptic bronchoscopy alveolar lavage combined with Meropenem in the treatment of the ICU patients with severe pneumonia can improve the clinical efficacy,promote the relief of clinical symptoms,shorten the ICU stay time,improve the levels of arterial blood gas indexes,and reduce the body’s inflammatory response.Moreover,it is superior to single Meropenem treatment.