摘要
目的探讨纤维支气管镜肺灌洗治疗昏迷合并重症肺部感染患者的疗效及对其血清降钙素原（PCT）及C-反应蛋白（CRP）表达水平的影响。
方法64例昏迷合并重症肺部感染患者根据建档顺序分组，每组32例。对照组采用常规干预措施，研究组在常规干预基础上进行纤维支气管镜肺灌洗治疗，两组均持续治疗10 d。疗程结束后统计对比两组临床疗效、临床症状改善时间、机械通气时间及住院时间，分析入院时及疗程结束后两组血清CRP、PCT及血气指标[二氧化碳分压（PaCO2）、氧分压（PaO2）]水平变化。
结果①临床疗效：研究组总有效率[90.63%（29/32）]高于对照组[68.75%（22/32）]，差异有统计学意义（P〈0.05）。②临床症状改善时间、住院时间及机械通气时间：研究组血象恢复正常时间、肺部啰音消失时间、体温恢复正常时间、住院时间、机械通气时间少于对照组，差异有统计学意义（P〈0.05）。③血清CRP、PCT水平：治疗前两组血清CRP、PCT水平比较，差异未见统计学意义（P〉0.05）；治疗后研究组血清CRP、PCT水平低于对照组，差异有统计学意义（P〈0.05）。④血气指标：治疗前两组PaCO2、PaO2水平比较，差异未见统计学意义（P〉0.05）；治疗后研究组PaCO2水平低于对照组，PaO2水平高于对照组，差异有统计学意义（P〈0.05）。
结论采用纤维支气管镜肺灌洗治疗昏迷合并重症肺部感染患者效果显著，可有效减少临床症状改善时间及机械通气时间，改善血气指标，降低血清PCT、CRP水平，提高治疗效果，值得推广。
ObjectiveTo investigate the effect of bronchofiberscope lung lavage on coma complicated with severe pulmonary infection and its effect on serum procalcitonin （PCT） and C-reactive protein （CRP） levels.MethodsSixty-four patients with coma complicated with severe pulmonary infection in hospital were divided into control group and study group according to archiving order. The patients of control group were treated with conventional intervention, on the basis of the control group, the patients of study group were treated with bronchoscopic lung lavage, the treatment lasted for 10 d. At the end of the treatment, the clinical efficacy, clinical improvement time, mechanical ventilation time and hospitalization time were compared between the two groups, and the serum CRP, PCT levels and blood gas parameters （PaCO2, PaO2） at admission and after the end of treatment were analyzed as well.Results① Clinical efficacy： the total effective rate of the study group was 90.63% （29/32）, which was higher than that of the control group [68.75% （22/32）], the difference was significant （P〈0.05）. ② The clinical symptom improvement time, hospitalization time and mechanical ventilation time： blood return to normal time, lung rales disappear time, body temperature back to normal time, hospitalization time and mechanical ventilation time of the study group were all significantly lower than those in the control group （P〈0.05）. ③Serum CRP and PCT levels： there was no significant difference in serum CRP or PCT levels between the two groups before treatment （P〉0.05）; after treatment, the serum CRP and PCT levels in the study group were lower than those in the control group （P〈0.05）. ④Blood gas index： there were no significant differences in the PaCO2 and PaO2 levels between the two groups before treatment （P〉0.05）; after treatment, the PaCO2 level in the study group was lower than that in the control group, and the PaO2 level was higher than that in the control group （P〈0.05）.ConclusionsBronchofibroscopy lung lavage is effective on coma complicated with severe pulmonary infection, it can effectively reduce the clinical symptoms improvement time and mechanical ventilation time, improve the blood gas index, reduce the serum PCT, CRP levels, improve the treatment effect, and it is worth promoting.
作者
崔成宏
Cui Chenghong(Department of Critical Medicine, the Third Hospital of Yangquan Coal Group, Yangquan 045000, Chin)
出处
《中国实用医刊》
2017年第18期7-10,共4页
Chinese Journal of Practical Medicine
关键词
纤维支气管镜肺灌洗
昏迷合并重症肺部感染
血清降钙素原
C-反应蛋白
Fiberbronchoscope pulmonary lavage
Coma complicated with severe pulmonary infection
Procalcitonin
C-reactive protein
