肺泡灌洗联合乙酰半胱氨酸雾化吸入治疗重症肺炎的疗效及对肺功能的影响

Effects of Alveolar Lavage Combined with Acetylcysteine Aerosol Inhalation on Severe Pneumonia and Lung Function

目的探讨乙酰半胱氨酸联合肺泡灌洗在治疗重度肺炎中的疗效及对肺功能的影响。方法随机选取2022年8月—2023年11月将乐县总医院收治的100例重症肺炎患者为研究对象,按照不同治疗方案分为对照组和观察组,各50例。对照组行单一的支气管镜肺泡灌洗治疗,观察组在对照组方案基础上联合吸入乙酰半胱氨酸溶液治疗,治疗周期均为2周。对比两组患者的临床疗效、肺功能、免疫功能以及不良反应发生情况。结果观察组临床治疗总有效率为98.00%(49/50),高于对照组的88.00%(44/50),但差异无统计学意义(χ^(2)=2.458,P=0.117)。治疗后,两组患者的1 s内最大呼出气容量(forced expiratory volume in one second,FEV_(1))、用力肺活量(forced vital capacity,FVC)、FEV_(1)/FVC水平均高于治疗前,观察组FEV_(1)、FVC、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P均<0.05)。治疗后,两组患者的免疫球蛋白A(immunglobulin A,IgA)、免疫球蛋白G(immunglobulin G,IgG)、免疫球蛋白M(immunglobulin M,IgM)水平均高于治疗前,观察组IgA、IgG、IgM水平均高于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率低于对照组,但差异无统计学意义(P>0.05)。结论乙酰半胱氨酸联合肺泡灌洗在治疗重度肺炎中,有利于改善免疫功能及肺功能,且治疗效果较好,安全性较高。

Objective To investigate the efficacy of acetylcysteine combined with alveolar lavage in the treatment of severe pneumonia and its effect on lung function.Methods A total of 100 patients with severe pneumonia admitted to Jiangle County General Hospital from August 2022 to November 2023 were randomly selected as the research objects.According to different treatment plans,they were divided into control group and observation group,with 50 cases in each group.The control group was treated with single bronchoscopy alveolar lavage,and the observation group was treated with inhalation of acetylcysteine solution on the basis of the control group.The treatment cycle was 2 weeks.The clinical efficacy,lung function,immune function and adverse reactions were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 98.00%(49/50)higher than 88.00%(44/50)in the control group,but the difference was not statistically significant(χ^(2)=2.458,P=0.117).After treatment,the levels of forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC in the two groups were higher than those before treatment,and the levels of FEV_(1),FVC and FEV_(1)/FVC in the observation group were higher than those in the control group,the differences were statistically significant(all P<0.05).After treatment,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in the two groups were higher than those before treatment,and the levels of IgA,IgG and IgM in the observation group were higher than those in the control group,the differences were statistically significant(all P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Acetylcysteine combined with alveolar lavage is beneficial to improve immune function and lung function in the treatment of severe pneumonia,and the treatment effect is good and the safety is high.