摘要
目的:观察电子支气管镜肺泡灌洗术(BAL)治疗重症肺炎的效果及对炎症因子水平的影响。方法:选取2017年12月-2021年10月上海市东方医院吉安医院收治的76例重症肺炎患者,依据随机数字表法分为对照组和研究组,每组38例。对照组采用常规治疗,研究组在常规治疗基础上采用BAL治疗。比较两组疗效、炎症因子[肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素1β(IL-1β)]水平及呼吸力学指标[肺动态顺应性(Cdyn)、气道阻力(RAW)、呼吸做功量(WOB)]。结果:研究组总有效率为92.11%,高于对照组的71.05%,差异有统计学意义(P<0.05)。治疗前,两组TNF-α、CRP、IL-1β水平比较,差异均无统计学意义(P>0.05);治疗7 d,两组TNF-α、CRP、IL-1β水平均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组Cdyn、RAW、WOB比较,差异均无统计学意义(P>0.05);治疗7 d,两组Cdyn均高于治疗前,RAW、WOB均低于治疗前,且研究组Cdyn高于对照组,RAW、WOB均低于对照组,差异均有统计学意义(P<0.05)。结论:重症肺炎患者采用BAL治疗效果较好,可下调炎症因子水平,提高呼吸力学。
Objective:To observe the effect of electronic bronchoscope alveolar lavage(BAL)in the treatment of severe pneumonia and its influence on the levels of inflammatory factors.Method:A total of 76 patients with severe pneumonia who were admitted to Shanghai Dongfang Hospital Ji’an Hospital from December 2017 to October 2021 were selected,they were divided into control group and study group according to the random number table method,with 38 cases in each group.The control group received conventional treatment,and the study group received BAL treatment on the basis of the conventional treatment.The curative effect,inflammatory factor[tumor necrosis factor alpha(TNF-α),C reactive protein(CRP),interleukin-1β(IL-1β)]levels and respiratory mechanics indexes[lung dynamic compliance(Cdyn),airway resistance(RAW),work of breathing(WOB)]were compared between two groups.Result:The total effective rate of the study group was 92.11%,which was higher than 71.05%of the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in TNF-α,CRP and IL-1βlevels between two groups(P>0.05);7 d of treatment,the TNF-α,CRP and IL-1βlevels of both groups were lower than those before treatment,and those of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in Cdyn,RAW and WOB between two groups(P>0.05);7 d of treatment,Cdyn of both groups were higher than those before treatment,RAW and WOB of both groups were lower than those before treatment,and Cdyn of the study group was higher than that of the control group,RAW and WOB of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment effect of BAL is better in patients with severe pneumonia,which can down-regulate the level of inflammatory factors and improve respiratory mechanics.
作者
周峻林
刘鸿宇
吴剑芹
陈林
卢明海
ZHOU Junlin;LIU Hongyu;WU Jianqin;CHEN Lin;LU Minghai(Shanghai Dongfang Hospital Ji’an Hospital,Ji’an 343000,China;不详)
出处
《中国医学创新》
CAS
2022年第21期163-166,共4页
Medical Innovation of China
关键词
重症肺炎
电子支气管镜肺泡灌洗术
炎症因子
呼吸力学
Severe pneumonia
Electronic bronchoscopy alveolar lavage
Inflammatory factors
Respiratory mechanics
