支气管肺泡灌洗联合血凝酶在支气管扩张合并咯血患者中的应用及对肺功能影响的研究

Study on the effect of bronchoalveolar lavage and blood coagulation in patients with bronchiectasis and hemoptysis

目的探讨支气管肺泡灌洗(bronchoalveolar lavage,BAL)联合血凝酶在支气管扩张合并咯血患者中的临床效果及对肺功能的影响。方法取2014年12月-2016年10月医院收治支气管扩张合并咯血患者84例,随机数字法分为对照组(n=42)和观察组(n=42)。对照组采用常规补液、氧疗、止血治疗,观察组待患者咯血量<50m L后采用BAL联合血凝酶治疗,疗程7天。采用德国耶格肺功能仪对2组治疗前、治疗后肺功能进行测定,比较2组临床疗效及对肺功能的影响。结果观察组治疗7天后退热、咳嗽咳痰、湿啰音、咯血消失时间,短于对照组(P<0.05);观察组治疗后7天肺功能FEV_1、FEV_1/FVC、FEV_1、PEF指标高于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论采用BAL联合血凝酶治疗支气管扩张合并咯血患者能改善患者肺功能,值得推广应用。

Objective To investigate the clinical effect of bronchoalveolar lavage( BAL) combined with blood coagulation in patients with bronchiectasis and hemoptysis. Methods A total of 84 patients with bronchiectasis and hemoptysis in our hospital from December 2014 to 2016 were randomly divided into the control group( n = 42)and the observation group( n = 42). The control group was treated with routine fluid replacement,oxygen therapy,hemostasis,and the observation group was treated with BAL combined with blood coagulation while their hemoptysis was lower than 50 mL. The German Jaeger spirometry on pulmonary function were measured and compared between the two groups before and after treatment. Their clinical curative effect and the effect on lung function were also compared. Results After 7-day treatment,fever,cough and expectoration,hemoptysis,and rales disappeared time were shorter in the observation group than in the control group( P < 0. 05). The levels of FEV1,FEV1/FVC,FEV1 and PEF of the observation group were higher than those of the control group( P < 0. 05) after treatment. There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion BAL combined with batroxobin in the treatment of bronchiectasis complicated with hemoptysis can improve their lung function,which is worthy of wide popularization and application.