Han Qiu, Chen Chun, Fu Ran, Tan Lan, Xia Lei
a Department of Neurology, Qingdao Municipal Hospital, Qingdao Clinical Medical School , Nanjing Medical University , Qingdao , Shandong , China.
b Department of Neurology, The Second People's Hospital of Huai'an , The Affiliated Huai'an Hospital of Xuzhou Medical University , Huai'an , Jiangsu , China.
Neurol Res. 2019 Mar;41(3):216-222. doi: 10.1080/01616412.2018.1548723. Epub 2019 Jan 18.
To investigate the efficacy and safety of portable fibrobronchoscopy on the non-severe ischemic stroke-associated pneumonia (SAP) patients with dysphagia.
A total of 86 non-severe ischemic SAP patients with dysphagia were randomly and equally divided into the treatment group and control group. The control group was given routine sputum suction, anti-infection drugs, and sputum-reducing drugs. The treatment group was treated with fiber-optic bronchoscopic sputum suction and alveolar lavage, and drug treatment same as the control group. The blood gases, inflammatory factors, clinical pulmonary infection score (CPIS), adverse reactions, and modified Rankin Scale (mRS) were compared.
The blood gases, serum inflammatory factors including procalcitonin (PCT), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α), and CPIS in the treatment group were superior to those in control group (P < 0.05). No significant difference was found in the incidence of adverse reactions between the two groups (P > 0.05). The mRS scores of the treatment group were significantly lower than those of control group 3 months after discharge.
Sputum suction and alveolar lavage with portable fibrobronchoscope can significantly improve the hypoxia and pulmonary infections, reduce the inflammatory response, and thus improve the prognosis, rendering suction and alveolar lavage with portable fibrobronchoscope as a safe and effective treatment for non-severe ischemic SAP patients with dysphagia.
探讨便携式纤维支气管镜对非重症缺血性脑卒中相关性肺炎(SAP)伴吞咽困难患者的疗效及安全性。
将86例非重症缺血性SAP伴吞咽困难患者随机等分为治疗组和对照组。对照组给予常规吸痰、抗感染药物及祛痰药物。治疗组采用纤维支气管镜吸痰及肺泡灌洗,并给予与对照组相同的药物治疗。比较两组的血气指标、炎症因子、临床肺部感染评分(CPIS)、不良反应及改良Rankin量表(mRS)评分。
治疗组的血气指标、血清炎症因子包括降钙素原(PCT)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α),以及CPIS均优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。治疗组出院3个月后的mRS评分显著低于对照组。
便携式纤维支气管镜吸痰及肺泡灌洗可显著改善非重症缺血性SAP伴吞咽困难患者的低氧血症及肺部感染,减轻炎症反应,从而改善预后,提示便携式纤维支气管镜吸痰及肺泡灌洗是治疗非重症缺血性SAP伴吞咽困难患者的一种安全有效的方法。