CT引导下采用纤维支气管镜气道灌洗对重症肺炎患者预后改善作用分析

Analysis of the effect of CT-guided fiberoptic bronchoscopy airway lavage on the prognosis of patients with severe pneumonia

目的分析重症肺炎患者在CT引导下采用纤维支气管镜气道灌洗对其预后的改善作用。方法根据检查方法将信阳一五四医院于2021年5月至2023年5月收治的94例重症肺炎患者分为对照组(47例,接受纤维支气管镜气道灌洗治疗)和观察组(47例,接受CT引导下采用纤维支气管镜气道灌洗治疗),评估2组临床治疗效果,并比较2组在生命体征指标、呼吸动力学指标以及临床相关指标方面的差异。结果与对照组相比,观察组的总有效率明显提高(94%与79%;χ^(2)=4.374,P<0.05);观察组在灌洗后10 min的收缩压(SBP)和舒张压(DBP)水平方面差异无统计学意义(P>0.05),但呼吸频率(RR)和心率(HR)明显下降(P<0.05);观察组灌洗后1 h的动态顺应性(Cdyn)水平升高幅度更为明显(P<0.05),而呼吸做功(WOB)、气道峰压(PIP)和气道阻力(Raw)水平下降幅度也更为显著(P<0.05);观察组在机械通气、抗生素使用及住院的时间方面均显著较短(P<0.05)。结论CT引导下采用纤维支气管镜气道灌洗对重症肺炎患者预后具有较好的应用效果,能够有效改善生命体征及呼吸动力学指标水平,并促进康复进程。

Objective To analyze the effect of CT-guided fiberoptic bronchoscopy airway lavage on the prognosis of patients with severe pneumonia.Methods A total of 94 patients with severe pneumonia admitted to Xinyang 154 Hospital from May 2021 to May 2023 were divided into control group(47 cases,treated with fiberoptic bronchoscopy airway lavage)and observation group(47 cases,treated with CT-guided fiberoptic bronchoscopy airway lavage)by inspection method.The clinical treatment effects of the two groups were evaluated.The differences in vital signs,respiratory dynamics and clinical related indicators between the two groups were compared.Results Compared with the control group,the total effective rate of the observation group was significantly increased(94%vs 79%)(χ^(2)=4.374,P<0.05).There was no significant difference in the level of systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the observation group 10min after lavage(P>0.05),but the respiratory rate(RR)and heart rate(HR)decreased significantly(P<0.05).At 1 hour after lavage,the level of dynamic compliance(Cdyn)in the observation group increased more significantly(P<0.05),while the work of breathing(WOB),peak airway pressure(PIP)and airway resistance(Raw)levels decreased more significantly(P<0.05).The time of mechanical ventilation,antibiotic use and hospitalization in the observation group were significantly shorter than those in the control group(P<0.05).Conclusion CT-guided fiberoptic bronchoscopy airway lavage has a good application effect on the prognosis of patients with severe pneumonia,which can effectively improve the vital signs and respiratory dynamics,and promote the rehabilitation process.