摘要
目的:探讨纤维支气管镜肺泡灌洗治疗支气管扩张合并肺部感染的效果及对气道炎症反应的影响。方法:选取2019年1月-2022年1月佳木斯市中心医院收治的80例支气管扩张合并肺部感染的患者,应用随机数字表法将其分为观察组(n=40)和对照组(n=40)。对照组接受常规治疗,观察组在对照组基础上加用纤维支气管镜肺泡灌洗,对比两组痰液性状评分、肺功能相关指标、感染相关指标、血清炎症因子水平。结果:治疗前,两组黏液密度(MD)、脓性黏液(MP)、黏液体积(MVP)评分差异均无统计学意义(P>0.05);治疗2周后,两组评分均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组第1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、最大呼气流量(PEF)、最大吸气压(MIP)及最大呼气压(MEP)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))及氧合指数(PaO_(2)/FiO_(2))水平差异均无统计学意义(P>0.05);治疗2周后,两组的PaCO_(2)均下降,观察组低于对照组,其余指标均上升,观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组可溶性尿激酶型纤溶酶原激活物受体(suPAR)、可溶性髓系细胞触发受体1(sTREM-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)、白细胞介素-23(IL-23)及转化生长因子-β(TGF-β)水平差异均无统计学意义(P>0.05);治疗2周后,两组指标均下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:纤维支气管镜肺泡灌洗治疗支气管扩张合并肺部感染可显著改善临床症状及肺功能、减轻感染及气道炎症反应。
Objective:To investigate the efficacy of alveolar lavage with fiberoptic bronchoscopy in the treatment of bronchiectasis combined with pulmonary infection and the effect on airway inflammatory response.Method:Eighty patients with bronchiectasis combined with pulmonary infection admitted to Jiamusi Central Hospital from January 2019 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)by applying the random number table method.The control group received conventional treatment,and the observation group added fiberoptic bronchoscopic alveolar lavage on the basis of the control group,and the sputum property scores,lung function-related indexes,infection-related indexes,and serum inflammatory factor levels were compared between the two groups.Result:Before treatment,the differences in mucus density(MD),purulent mucus(MP),and mucus volume(MVP)scores between the two groups were not statistically significant(P>0.05);after 2 weeks of treatment,the scores of both groups decreased,those of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in the levels of first second forceful expiratory volume(FEV_(1)),forced vital capacity(FVC),peak expiratory flow(PEF),maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and oxygenation index(PaO_(2)/FiO_(2))between the two groups(P>0.05);after 2 weeks of treatment,PaCO_(2) decreased in both groups and that in the observation group was lower than that in the control group,while the remaining indexes increased and those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Before treatment,the levels of soluble urokinase-type fibrinogen activator receptor(suPAR),soluble myeloid trigger receptor 1(sTREM-1),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),interleukin-4(IL-4),interleukin-23(IL-23)and transforming growth factor-β(TGF-β)in the two groups were not statistically significant(P>0.05);after 2 weeks of treatment,the indexes in both groups decreased,those of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Alveolar lavage with fiberoptic bronchoscopy for bronchiectasis combined with lung infection can significantly improve clinical symptoms and lung function,reduce infection and airway inflammatory response.
作者
柴明思
CHAI Mingsi(Jiamusi Central Hospital,Heilongjiang Province,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2023年第18期10-14,共5页
Medical Innovation of China
关键词
纤维支气管镜
肺泡灌洗
支气管扩张
肺部感染
气道炎症反应
肺功能
Fiberoptic bronchoscopy
Alveolar lavage
Bronchodilation
Pulmonary infection
Airway inflammatory response
Pulmonary function
