摘要
目的分析支气管镜肺泡灌洗(BAL)联合无创通气治疗重症肺炎合并呼吸衰竭的疗效。方法选取2014年5月至2017年5月在晋中市中医院治疗的重症肺炎合并呼吸衰竭患者120例,对照组(50例)采用无创通气治疗,试验组(70例)采用无创通气联合BAL治疗。治疗后1周,将两组患者治疗效果、血气指标[动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、血氧饱和度(SaO2)]、肺功能指标[1秒用力呼气量(FEV1)、最大呼气中期流速(FEF)、肺一氧化碳弥散量(DLCO)]、炎症指标[血清炎症因子高迁移率族蛋白(HMGB-1)、可溶性髓系细胞触发受体-1(sTrem-1)、γ-干扰素(IFN-γ)]进行统计对比。结果试验组有效率(95.0%)与对照组(80.0%)比较,差异有统计学意义(χ^2=10.29,P<0.05);试验组治疗后血气指标均优于对照组,差异有统计学意义(P<0.05);试验组治疗后肺部通气功能均优于对照组,差异有统计学意义(P<0.05);试验组治疗后肺部炎症改善情况优于对照组,差异有统计学意义(P<0.05)。结论无创通气联合BAL可有效治疗肺部炎症反应,改善肺通气功能及血气指标,提高治疗效果。
Objective To analyze the efficacy of bronchoalveolar lavage(BAL)combined with non-invasive ventilation on severe pneumonia complicated with respiratory failure.Methods A total of 120 patients with severe pneumonia complicated with respiratory failure treated in Jinzhong Hospital of Traditional Chinese Medicine from May 2014 to May 2017 were selected.The 50 cases in the control group were treated by non-invasive ventilation,and the 70 cases in the experimental group were treated by non-invasive ventilation combined with BAL.One week after treatment,the therapeutic effect,blood gas indexes(PaO2,PaCO2,SaO2),lung function indexes(FEV1,FEF,DLCO),inflammation indexes(HMGB-1,sTREM,IFN-gamma)were compared between the two groups.Results The effective rate in the experimental group(95.0%)was higher than that in the control group(80.0%),and the difference was significant(χ^2=10.29,P<0.05).After treatment,the blood gas indexes in the experimental group were better than those in the control group,and the differences were significant(P<0.05).After treatment,the pulmonary ventilation function of the experimental group was better than that of the control group(P<0.05).The improvement of lung inflammation in the experimental group was better than that in the control group,and the difference was significant(P<0.05).Conclusions Non-invasive ventilation combined with BAL can effectively treat pulmonary inflammatory response,improve the lung ventilation function and blood gas index,and improve the therapeutic effect.
作者
王晓峰
Wang Xiaofeng(Department of Pulmonary Disease,Jinzhong Hospital of Traditional Chinese Medicine,Jinzhong 030600,China)
出处
《中国实用医刊》
2019年第2期72-74,共3页
Chinese Journal of Practical Medicine
关键词
支气管镜肺泡灌洗
无创通气
重症肺炎
呼吸衰竭
Bronchoscopy alveolar lavage
Non-invasive ventilation
Severe pneumonia
Respiratory failure
