摘要
目的研究电子支气管镜联合阿米卡星肺泡灌洗对重症肺部患者炎症反应及肺上皮细胞功能的影响。方法采用回顾性分析方法,选取2020年月1月至2021年6月空军第986医院收治入院的72例重症肺部感染患者作为研究对象,根据治疗方式分为对照组(n=36)与研究组(n=36)。对照组行常规治疗,研究组在常规治疗基础上行电子支气管镜联合阿米卡星肺泡灌洗。比较两组患者治疗前后肺功能指标[最大通气量(MMV)、最大呼气中期流量(MMEF)、功能残气量(FRC)]、炎症反应指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、SP蛋白(SP-D)]、肺部活化控制趋因子(PARC/CCL18)、血气指标[氧合指数(PaO_(2)/FiO_(2))、动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))]水平与预后(机械通气时间、排痰量、住院时间)情况。结果治疗前,两组肺功能指标、炎症反应指标、PARC/CCL18、血气指标水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的MMV、MMEF、FRC、PaO_(2)/FiO_(2)、PaO_(2)、SaO_(2)水平较治疗前明显升高,hs-CRP、TNF-α、SP-D、PARC/CCL18水平较治疗前明显降低,差异均有统计学意义(P<0.05);且研究组患者MMV、MMEF、FRC、PaO_(2)/FiO_(2)、PaO_(2)、SaO_(2)水平均明显高于对照组,hs-CRP、TNF-α、SP-D、PARC/CCL18水平均明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者排痰量为(49.21±3.38)mL,明显高于对照组[(36.49±4.12)mL],机械通气时间、住院时间为(6.31±1.54)、(10.38±3.42)d,明显短于对照组[(6.31±1.54)、(10.38±3.42)d],差异均有统计学意义(P<0.05)。结论重症肺部感染治疗中采用电子支气管镜联合阿米卡星肺泡灌洗的疗效显著,可有效减轻患者炎症反应,改善其肺上皮细胞功能及肺功能,促使其快速康复。
Objective To study the effect of electronic bronchoscopy combined with amikacin bronchoalveolar lavage on inflammatory response and pulmonary epithelial cell function in severe pulmonary patients.Methods A retrospective analysis method,a total of 72 patients with severe pulmonary infection who were admitted to the 986th Hospital of the Air Force from January 2020 to June 2021 were selected as the research subjects,according to the treatment were divided into control group(n=36)and group(n=36).The control group receivedroutine treatment,the study group received electronic bronchoscopy combined with amikacin bronchoalveolar lavage on the basis of conventional treatment.Lung function indexes[maximum volume of air(MMV),maximum mid-expiratory flow(MMEF),functional residual air(FRC)],inflammatory response indexes[hs-CRP,TUMOR necrosis factor-α(TNF-α),SP protein(SP-D)]and lung activation control factor(PARC/CCL18),blood gas index[oxygenation index(PaO_(2)/FiO_(2)),arterial partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2))]before and after treatment and prognosis(mechanical ventilation time,sputum volume,length of hospital stay)were compared between the two groups.Results Before treatment,there were no statistically significant differences in lung function index,inflammatory response index,PARC/CCL18 and blood gas index between the two groups(P>0.05).Compared with before treatment,the levels of MMV,MMEF,FRC,PaO_(2)/FiO_(2),PaO_(2) and SaO_(2) were higher,and the levels of hS-CRP,TNF-α,SPD and PARC/CCL18 were lower in 2 groups after treatment,the differences were statistically significant(P<0.05).After treatment,MMV,MMEF,FRC,PaO_(2)/FiO_(2),PaO_(2),SaO_(2) levels were higher,hs-CRP,TNF-α,SPD,PARC/CCL18 levels in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The sputum volume in the study group was(49.21±3.38)mL,which was significantly higher than that in the control group[(36.49±4.12)mL],and the mechanical ventilation time and hospital stay were(6.31±1.54),(10.38±3.42)d,which were significantly shorter than those in the control group[(6.31±1.54),(10.38±3.42)d],the differences were statistically significant(P<0.05).Conclusion In the treatment of severe pulmonary infection,electronic bronchoscopy combined with amikacin alveolar lavage has significant efficacy,which can effectively reduce the inflammatory response of patients,improve the function of pulmonary epithelial cells and lung function,and promote their rapid recovery.
作者
秦毅
巩亚婷
王卓
QIN Yi;GONG Ya-ting;WANG Zhuo(Department of Intensive Care Medicine,986 Hospital of Air Force,Xi'an Shaanxi 710054,China;Department of Respiratory Medicine,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712000,China)
出处
《临床和实验医学杂志》
2022年第13期1376-1380,共5页
Journal of Clinical and Experimental Medicine
基金
陕西省自然科学基础研究计划项目(编号:S2020-JC-QN-1129)。
关键词
重症肺部感染
电子支气管镜
阿米卡星
肺泡灌洗
炎症反应
肺上皮细胞功能
Severe pulmonary infection
Electronic bronchoscopy
Amikacin
Bronchoalveolar lavage
Inflammatory response
Lung epithelial cell function
