摘要
目的探讨支气管镜肺泡灌洗在支气管扩张治疗中的应用效果。方法选取2012年1月-2017年1月在我院进行治疗的支气管扩张患者60例,随机分为研究组和对照组,两组各30例。对所有患者给予祛痰药物及抗菌药物治疗,研究组在此基础上使用支气管镜肺泡灌洗治疗,对照组在此基础上使用体位引流排痰治疗,两组均行为期两周的治疗。结果治疗前,研究组动脉血氧分压(Pa O2)(65±11)mm Hg,与对照组[(64±12)mm Hg]差异无统计学意义(P>0.05)。治疗2周后,研究组Pa O2为(79±14)mm Hg,对照组为(69±15)mm Hg,两组的动脉血氧分压得到改善,研究组显著优于对照组(P=0.031)。研究组治疗后显效14例,好转14例,总有效率93.33%;对照组治疗后显效7例,好转12例,总有效率63.33%,研究组总有效率显著高于对照组(P=0.027)。治疗前两组血清肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)、超敏C反应蛋白(high sensitive C reactive protein,hs-CRP)差异无统计学意义(P均>0.05);治疗后,研究组TNF-α[(11.98±1.89)nmol/L vs(23.25±3.48)nmol/L,P=0.013]和hs-CRP[(37.21±6.24)mg/L vs(68.05±7.17)mg/L,P=0.021]显著低于对照组。结论应用支气管镜肺泡灌洗治疗能够有效改善患者的动脉血气并降低炎性因子水平。
Objective To explore the effect of bronchoscopic alveolar lavage on bronchiectasis. Methods A total of 60 patients with bronchiectasis treated in our hospital from January 2012 to January 2017 were randomly divided into study group （n=30） and control group （n=30）. All the patients were given expectorant drugs and antibiotics. In addition, the study group was treated with bronchoscopic alveolar lavage, while the control group was treated with postural drainage. The treatment lasted for two weeks. Results Before treatment, the arterial oxygen partial pressure （Pat2） was （65 ±11） mmHg in the study group, and （64 ± 12） mmHg in the control group, the difference between the two groups was not statistically significant （P 〉 0.05）. After 2 weeks of treatment, Pat2 was （79± 14） mmHg in the study group, and （69 ± 15） mmHg in the control group. It improved in both two groups, but the improvement of the study group was significantly greater than that of the control group （P=0.031）. In the study group, 14 cases improved markedly, 14 cases improved, with the total effective rate of 93.33%. In the control group, 7 cases markedly improved, 12 cases improved with the total effective rate of 63.33%. The total effective rate in the study group was significantly higher than that in the control group （P=0.027）. Before treatment, there was no significant difference in the serum TNF- α level and high sensitive C reactive protein （hs-CRP） level between two groups （P 〉 0.05）. After treatment, the TNF- α and hs-CRP levels were significantly lower in study group than those of control group [（11.98 ± 1.89） nmol/L vs （23.25 ±3.48） nmol/L, P=-0.013; （37.21± 6.24） mg/L vs （68.05± 7.17） mg/L, P=0.002]. Conclusion Bronchoscopic alveolar lavage can effectively improve the arterial oxygen partial pressure and reduce the level of inflammatory factors in patients with bronchiectasis.
作者
夏德刚
李传文
李继刚
XIA Degang1, LI Chuanwen1, LI Jigang2(1Department of Respiratory; 2Clinical Laboratory Sixth People＇s Hospital of Xuzhou City, Xuzhou 221006, Jiangsu Province, China)
出处
《解放军医学院学报》
CAS
2018年第3期205-207,214,共4页
Academic Journal of Chinese PLA Medical School
关键词
支气管扩张
支气管镜肺泡灌洗
临床效果
动脉血氧分压
炎性因子
bronchiectasis
bronchoalveolar lavage
clinical effect
arterial partial pressure of oxygen
inflammatory cytokine
