纤维支气管镜下支气管灌洗治疗重症肺部感染
Bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection.
作者信息
Zhao Yuqin, Dai Xuemei, Ji Jinzhi, Cheng Ping
机构信息
Yuqin Zhao, Emergency Intensive Care Unit, Binzhou People's Hospital, Shandong 256610, China.
Xuemei Dai, Health Management Center, Binzhou People's Hospital, Shandong 256610, China.
出版信息
Pak J Med Sci. 2020 Mar-Apr;36(3):396-401. doi: 10.12669/pjms.36.3.1539.
OBJECTIVE
To investigate the clinical efficacy of bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection.
METHODS
One hundred forty eight patients with severe pulmonary infection who were admitted to our hospital from October 2016 to December 2017 were included in this study. According to the random number table method, they were divided into a control group and an observation group with 79 patients each. The control group was given conventional treatment, while the observation group was given bronchoalveolar lavage with fiberoptic bronchoscopy on the basis of the treatment in the control group. The clinical efficacy of the two groups was compared, the duration of mechanical ventilation, antibiotic use and symptoms improvement of the two groups were recorded, and the respiratory mechanics parameters, serum procalcitonin (PCT) and transforming growth factor β (TGF-β) level were measured before and after treatment.
RESULTS
The duration of mechanical ventilation, antibiotic use, respiratory failure correction, body temperature decline and white blood cell recovery in the observation group were significantly shorter than those in the control group (P<0.05). The total efficacy of the observation group was significantly higher than that of the control group (92.4% vs. 74.7%). The respiratory mechanics parameters of the two groups after treatment were higher than those before treatment (P<0.05) and the increase of the observation group was more obvious than that of the control group (P<0.05). The serum PCT and TGF-β levels of the two groups after treatment were lower than those before treatment (P<0.05), and the decrease level in the observation group was more obvious (P<0.05).
CONCLUSION
Bronchial lavage under fiberoptic bronchoscopy can improve the clinical efficacy, accelerate the improvement of clinical symptoms and respiratory mechanics parameters, significantly reduce the PCT and TGF-β levels, and promote the rapid recovery of patients in the treatment of severe pulmonary infection.
目的
探讨纤维支气管镜下支气管灌洗治疗重症肺部感染的临床疗效。
方法
选取2016年10月至2017年12月我院收治的148例重症肺部感染患者纳入本研究。根据随机数字表法，将其分为对照组和观察组，每组79例。对照组给予常规治疗，观察组在对照组治疗的基础上给予纤维支气管镜下支气管肺泡灌洗。比较两组的临床疗效，记录两组的机械通气时间、抗生素使用情况及症状改善情况，并测定治疗前后的呼吸力学参数、血清降钙素原（PCT）和转化生长因子β（TGF-β）水平。
结果
观察组的机械通气时间、抗生素使用时间、呼吸衰竭纠正时间、体温下降时间及白细胞恢复时间均明显短于对照组（P<0.05）。观察组的总有效率明显高于对照组（92.4% 对74.7%）。两组治疗后的呼吸力学参数均高于治疗前（P<0.05），且观察组升高更明显（P<0.05）。两组治疗后的血清PCT和TGF-β水平均低于治疗前（P<0.05），且观察组下降更明显（P<0.05）。
结论
纤维支气管镜下支气管灌洗在重症肺部感染治疗中可提高临床疗效，加速临床症状及呼吸力学参数的改善，显著降低PCT和TGF-β水平，促进患者快速康复。
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