摘要
目的探讨纤维支气管镜肺泡灌洗对重症肺炎患儿机体炎症反应和血气指标的影响。方法选取94例重症肺炎患儿作为研究对象,按照简单随机分组法分为对照组和观察组,各47例。对照组给予抗感染、雾化、拍背吸痰、解痉、退热和纠正水电解质紊乱等常规对症治疗,观察组在对照组基础上给予纤维支气管镜肺泡灌洗治疗,均持续治疗7 d。观察2组治疗前后血清C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平、动脉血氧分压[p(O 2)]、动脉血氧饱和度(SaO 2)、动脉二氧化碳分压[p(CO 2)]和急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分变化,并评估2组的临床疗效。结果治疗后,2组血清CRP、PCT和TNF-α水平均较治疗前下降,且观察组血清CRP、PCT和TNF-α水平低于对照组,差异均有统计学意义(P<0.05);治疗后,2组p(O 2)、SaO 2均较治疗前升高,p(CO 2)均较治疗前下降,且观察组p(O 2)、SaO 2高于对照组,p(CO 2)低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组APACHEⅡ评分低于对照组,总有效率95.74%高于对照组80.85%,差异均有统计学意义(P<0.05)。结论纤维支气管镜肺泡灌洗能有效减轻重症肺炎患儿的炎症反应,改善血气指标水平,提升临床疗效。
Objective To investigate the effect of bronchoscopic alveolar lavage on inflammatory response and blood gas index in children with severe pneumonia.Methods A total of 94 children with severe pneumonia in our hospital wer randomly divided into control group and observation group,with 47 cases in each group.The control group was given routine symptomatic treatment,such as anti-infection,atomized inhalation therapy,and back-patting sputum expectoration,antispasmodic,antipyretic treatments and correction of water electrolyte disorder.The observation group was given bronchoscopic alveolar lavage on the basis of the control group,the treatment was lasted for 7 days.The changes of serum C reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),arterial oxygen partial pressure[p(O 2)],arterial oxygen saturation(SaO 2),arterial carbon dioxide partial pressure[p(CO 2)],acute physiology and chronic health statusⅡ(APACHE-Ⅱ)scores before and after treatment were observed,and the clinical effects of the two groups were evaluated.Results After treatment,the levels of serum CRP,PCT and TNF-αin the two groups were significantly lower than those before treatment(P<0.05),and were significantly lower in the observation group than those in the control group(P<0.05).After treatment,p(O 2)and SaO 2 in the two groups were significantly higher,and p(CO 2)was significantly lower than treatment before(P<0.05),and the observation group changed more significantly compared with the control group(P<0.05).After treatment,APACHEⅡscore in the observation group was significantly lower(P<0.05),and total effective rate was significantly higher than that in the control group(95.74%vs.80.85%,P<0.05).Conclusion Bronchoscopic alveolar lavage can effectively reduce the inflammatory reactions and improve the blood gas index level,and improve the clinical effects in children with severe pneumonia.
作者
郭正平
张红
GUO Zhengping;ZHANG Hong(Pediatric Department,Wuxue First People′s Hospital in Hubei Province,Wuxue,Hubei,435499;Department of Oncology,Wuxue First People′s Hospital in Hubei Province,Wuxue,Hubei,435499)
出处
《实用临床医药杂志》
CAS
2020年第1期50-53,共4页
Journal of Clinical Medicine in Practice
关键词
重症肺炎
儿童
纤维支气管镜肺泡灌洗
炎症反应
血气指标
severe pneumonia
children
bronchoscopic alveolar lavage
inflammatory response
blood gas index
