纤维支气管镜肺泡灌洗吸痰术联合血必净治疗危重症监护室肺部感染患者的效果及对BNP、TLR-4水平的影响

Effect of Fiberoptic Bronchoalveolar Lavage and Sputum Combined with Xuebijing on Patients with Pulmonary Infection in Intensive Care Unit and Its Effect on BNP and TLR-4 Levels

目的探讨纤维支气管镜肺泡灌洗吸痰术联合血必净治疗危重症监护室肺部感染患者的效果及对BNP、TLR-4水平的影响。方法将浙江大学医学院附属第一医院ICU重症监护室2015年7月—2017年1月收治的重症肺部感染的70例患者随机分为对照组和观察组,每组35例。对照组患者采用纤维支气管镜肺泡灌洗吸痰术进行治疗,观察组患者采用纤维支气管镜肺泡灌洗吸痰术联合血必净进行治疗。比较两组患者治疗后的临床疗效、临床相关指标、症状缓解时间及治疗前后BNP、TLR-4水平的变化情况。结果观察组治疗后的有效率为94.3%显著高于对照组的88.6%(P<0.05);观察组的机械通气、抗菌药物使用及ICU入住时间均显著短于对照组(P<0.05);观察组患者的咳嗽、发热及肺部啰音的缓解时间均显著短于对照组(P<0.05);两组患者治疗后BNP和TLR-4水平相比于治疗前均有显著降低(P<0.05),且观察组治疗后BNP和TLR-4水平均显著低于对照组(P<0.05)。结论纤维支气管镜肺泡灌洗吸痰术联合血必净能显著提高危重症监护室肺部感染患者的治疗效果。

Objective To explore the effect of fiberoptic bronchoalveolar lavage and sputum combined with Xuebijing on patients with pulmonary infection in intensive care unit and its effect on BNP and TLR-4 levels.Methods 70 cases of severe pulmonary infection in ICU intensive care unit of First Affiliated Hospital of Zhejiang University School of Medicine from July2015 to January 2017 were randomly divided into control group and observation group,35 cases in each group.The control group was treated with fiberoptic bronchoalveolar lavage and sputum aspiration by fiberoptic bronchoscopy.The observation group was treated with bronchoscopic bronchoalveolar lavage and sputum aspiration combined with Xuebijing.The clinical efficacy,clinical related indicators,symptom relief time,and the changes of BNP and TLR-4 levels before and after treatment were compared between the two groups.Results The effective rate of the observation group after treatment was 94.3%,which was significantly higher than 88.6%of control group(P<0.05).The mechanical ventilation,the use of antibacterial drugs and the time of ICU stay in the observation group were significantly shorter than those of control group(P<0.05).The time of cough,fever and rale in observation group was significantly shorter than those of control group(P<0.05).After treatment,the levels of BNP and TLR-4 were significantly lower than those before treatment(P<0.05),and the levels of BNP and TLR-4 in the observation group were significantly lower than those in control group(P<0.05).Conclusion Fiberoptic ronchoalveolar lavage and sputum combined with Xuebijing can significantly improve the therapeutic effect of patients with pulmonary infection in intensive care unit.