摘要
目的:观察乙酰半胱氨酸联合纤维支气管镜肺泡灌洗术(BAL)治疗老年重症肺炎(SP)患者的效果。方法:回顾性分析2019年9月至2020年9月该院收治的96例老年SP患者的临床资料,按照治疗方法不同分为研究组与对照组各48例。对照组行BAL治疗,研究组在对照组基础上联合乙酰半胱氨酸治疗,比较两组临床疗效、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平、症状消失时间、肺功能指标[呼气流量峰值(PEF)、第1秒用力呼气容积(FEV)、用力肺活量(FVC)、FEV/FVC、最大呼气中段流量(MMF)]水平和不良反应发生率。结果:研究组治疗总有效率为95.83%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗后,两组CRP、IL-6水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组胸痛、咳痰、咳嗽、肺啰音消失时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组PEF、FEV、FVC、FEV/FVC和MMF水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:乙酰半胱氨酸联合BAL治疗老年SP患者可提高治疗总有效率和肺功能指标水平,缩短症状消失时间,以及降低炎性因子水平,效果优于单纯BAL治疗。
Objective: To observe effects of Acetylcysteine combined with fiberoptic bronchoscopy alveolar lavage in treatment of elderly patients with severe pneumonia(SP). Methods: The clinical data of 96 elderly SP patients admitted to the hospital from September 2019 to September 2020 were retrospectively analyzed. According to different treatment methods, they were divided into study group and control group, 48 cases in each.The control group was treated with BAL, while the study group was treated with Acetylcysteine on the basis of that of the control group. The clinical efficacy, the inflammatory factors [C-reactive protein(CRP), interleukin-6(IL-6)] levels, the symptom disappearance time, the lung function indicators [peak expiratory flow(PEF), forced expiratory volume in the first second(FEV), forced vital capacity(FVC), FEV/FVC, maximum mid-expiratory flow(MMF)] levels, and incidence of adverse reactions were compared between the two groups. Results: The total effective rate of treatment in the study group was 95.83%, which was significantly higher than 83.33% in the control group, and the difference was statistically significant(P<0.05).After the treatment, the levels of CRP and IL-6 in the two groups were lower than those before treatment, those in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). The disappearance time of chest pain, sputum, cough and lung rale in the study group was shorter than that in the control group, and the differences were statistically significant(P<0.05). After the treatment, the levels of PEF, FEV, FVC, FEV/FVC and MMF in the two groups were higher than those before the treatment, those in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: Acetylcysteine combined with BAL in the treatment of the elderly SP patients can improve the total effective rate of treatment and the levels of lung function indicators, shorten the symptom disappearance time, and reduce the levels of inflammatory factors. Moreover, it is superior to single BAL treatment.
作者
陈建国
柯其胜
CHEN Jianguo;KE Qisheng(Hubei Huangshi Aikang Hospital,Department of Respiratory Medicine,Huangshi 435000 Hubei,China;Hubei Huangshi Aikang Hospital,Department of Cardiovascular Medicine,Huangshi 435000 Hubei,China)
出处
《中国民康医学》
2022年第21期29-31,50,共4页
Medical Journal of Chinese People’s Health
关键词
老年
重症肺炎
纤维支气管镜肺泡灌洗术
乙酰半胱氨酸
炎性因子
肺功能
不良反应
Elderly
Severe pneumonia
Fiberoptic bronchoscopy alveolar lavage
Acetylcysteine
Inflammatory factors
Lung function
Adverse reaction
