文章摘要

纤维支气管镜治疗重症肺部感染的疗效及对肺功能、炎症因子的影响

作者: 1刘娜, 1李丹, 1刘杨, 1吕奕
1 首都医科大学附属北京同仁医院重症医学科,北京 100730
通讯: 刘娜 Email: liunn88@163.com
DOI: 10.3978/j.issn.2095-6959.2021.09.014

摘要

目的:探讨纤维支气管镜治疗重症肺部感染的疗效及对肺功能、炎症因子的影响。方法:选取2017年5月至2020年5月首都医科大学附属北京同仁医院收治的122例重症肺部感染患者,按照随机数字表法分为观察组与对照组,每组各61例,对照组予以常规抗感染治疗,10 d为1个疗程,观察组在对照组的基础上加以纤维支气管镜进行治疗,3次/周,每次10~20 min,10 d为1个疗程。对比两组治疗有效率、症状消失时间、治疗前后炎症因子水平、血气指标和肺功能。结果:观察组患者治疗总有效率为88.52%,明显高于对照组的73.77%;观察组症状消失时间明显短于对照组;观察组白细胞(white blood cell,WBC)、降钙素原(procalcitonin,PCT)以及超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平明显低于对照组;观察组血氧饱和度(oxygen saturation,SaO2)、动脉氧分压(partial pressure of oxygen,PaO2)明显高于对照组,二氧化碳分压(partial pressure of carbon dioxide,PaCO2)明显低于对照组;观察组最大通气量(maximum expiratory volume,MMV)、肺总量(total lung capacity,TLC)、1 s用力呼气量(forced expiratory volume of 1 s,FEV1)以及最大呼气中期流量(maximum mid-expiratory flow,MMEF)明显高于对照组(均P<0.05)。结论:纤维支气管镜治疗有利于提高重症肺部感染患者的临床疗效,缩短其症状消失时间,降低炎症因子水平,改善血气指标,提高肺功能。
关键词: 纤维支气管镜;重症肺部感染;肺功能;炎症因子;临床疗效

Efficacy of fiberoptic bronchoscopy in the treatment of severe pulmonary infection and its effect on pulmonary function and inflammatory factors

Authors: 1LIU Na, 1LI Dan, 1LIU Yang, 1LÜ Yi
1 Intensive Care Unit, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

CorrespondingAuthor: LIU Na Email: liunn88@163.com

DOI: 10.3978/j.issn.2095-6959.2021.09.014

Abstract

Objective: To investigate the efficacy of fiberoptic bronchoscopy in the treatment of severe pulmonary infection and its effect on pulmonary function and inflammatory factors. Methods: A total of 122 patients with severe pulmonary infection treated in our hospital from May 2017 to May 2020 were selected and were randomly divided into an observation group (n=61) and a control group (n=61). The control group was treated with routine anti-infective therapy for 10 days. On the basis of the control group, the observation group was treated with fiberoptic bronchoscope for 3 times/week for 10–20 min each time, and 10 days was a course of treatment. The effective rate of treatment, time of symptom disappearance, the level of inflammatory factors, blood gas index and pulmonary function before and after treatment were compared between the two groups. Results: The total effective rate was significantly higher in the observation group (88.52%) than that in the control group (73.77%). Time of symptom disappearance in the observation group was significantly shorter than that in the control group. The levels of white blood cell (WBC), procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP) in the observation group were significantly lower than those in the control group. The oxygen saturation (SaO2) and arterial partial pressure of oxygen (PaO2) were significantly higher in the observation group than those in the control group, while the partial pressure of carbon dioxide (PaCO2) was significantly lower than that in the control group. The maximum expiratory volume (MMV), total lung capacity (TLC), forced expiratory volume of 1 s (FEV1) and maximum mid-expiratory flow (MMEF) were significantly higher in the observation group than those in the control group (P<0.05). Conclusion: Fiberoptic bronchoscopy can improve the clinical effect, shorten the time of symptom disappearance, reduce the level of inflammatory factors, improve blood gas index as well as lung function in patients with severe pulmonary infection.
Keywords: fiberoptic bronchoscope; severe pulmonary infection; pulmonary function; inflammatory factors; clinical efficacy