摘要
目的:探究经鼻高流量湿化氧疗(NFNC)联合肺泡灌洗治疗重症肺炎合并呼吸衰竭的临床效果。方法:随机硬币抛掷法将70例重症肺炎合并呼吸衰竭患者均分为两组。患者入组后均接受常规治疗,对照组在常规治疗基础上给予NFNC;观察组给予NFNC联合肺泡灌洗。对比两组治疗前后血气分析[二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、血氧饱和度(SpO_(2))和氧合指数(P/F)]、炎症反应[高迁移率族蛋白-1(HMGB-1)、可溶性髓系细胞触发受体-1(sTREM)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、氧化应激反应[丙二醛(MDA)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)水平]和临床效果。结果:与对照组比,观察组PaCO_(2)明显下降,PaO_(2)、SpO_(2)、P/F水平明显升高,血清HMGB-1、sTREM、TNF-α、IL-6、MDA、LPO明显下降,SOD水平均明显升高,比较差异具有统计学意义(均P<0.05)。观察组总体临床效果显著优于对照组,尤其显效率明显高于对照组(均P<0.05)。结论:NFNC联合肺泡灌洗是治疗重症肺炎合并呼吸衰竭行之有效的方案,可有效改善患者血气分析,缓解机体炎症和氧化应激反应,促进病情恢复,提高临床治疗效果。
Objective:To explore the clinical effect of nasal high-flow humidified oxygen therapy(NFNC)combined with bronchoalveolar lavage in the treatment of severe pneumonia with respiratory failure.Methods:A total of 70 patients with severe pneumonia and respiratory failure were divided into two groups by random coin tossing method.All patients received conventional treatment after enrollment,the control group was given NFNC on the basis of conventional treatment,and the observation group was given NFNC combined with bronchoalveolar lavage.The levels of blood gas indicators[partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SpO_(2))and oxygenation index(P/F)],inflammatory response indicators[high mobility group box protein-1(HMGB-1),soluble myeloid cell trigger receptor-1(sTREM),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],oxidative stress indicators[malondialdehyde(MDA),lipid peroxide(LPO),superoxide dismutase(SOD)]before and after treatment and the clinical effect were compared between the two groups.Results:Compared with the control group,the PaCO_(2) in the observation group decreased significantly,the levels of PaO_(2),SpO_(2),and P/F increased significantly,the serum HMGB-1,sTREM,TNF-α,IL-6,MDA,and LPO decreased significantly,and the SOD level increased significantly(all P<0.05).The overall clinical effect of the observation group was significantly better than that of the control group,especially the apparent rate was significantly higher than that of the control group(all P<0.05).Conclusion:NFNC combined with bronchoalveolar lavage is an effective solution for the treatment of severe pneumonia with respiratory failure,which can effectively improve the blood gas indicators of patients,relieve the body’s inflammation and oxidative stress response,promote the recovery of the disease,and improve the clinical treatment effect.
作者
谢波
高颖
XIE Bo;GAO Ying(Department of Respiratory and Critical Care Medicine,the Fourth People’s Hospital of Shaanxi,Xi’an 710043,China)
出处
《陕西医学杂志》
CAS
2023年第1期49-52,共4页
Shaanxi Medical Journal
基金
陕西省重点研发计划项目(2018SF-2667)。
关键词
肺炎
重症
呼吸衰竭
经鼻高流量湿化氧疗
肺泡灌洗
Pneumonia
Severe case
Respiratory failure
Nasal high-flow humidified oxygen therapy
Bronchoalveolar lavage
