摘要
目的探讨无创正压通气联合支气管镜肺泡灌洗治疗重症肺部感染的临床效果。方法选取86例重症肺部感染患者进行研究,将所有患者以抽签法随机分为对照组和观察组,各43例。对照组在常规基础方案上予以无创正压通气治疗,观察组在对照组治疗基础上联合支气管镜肺泡灌洗治疗。对比两组患者临床疗效、血气指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、甲状腺功能指标[游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))]水平。结果观察组治疗总有效率达到93.02%(40/43),高于对照组的72.09%(31/43)(P<0.05)。治疗后,观察组PaO_(2)(66.14±5.79)mm Hg(1 mm Hg=0.133 kPa)、SaO_(2)(97.34±1.58)%高于对照组的(62.65±5.82)mm Hg、(95.06±1.44)%,PaCO_(2)(30.27±4.16)mm Hg低于对照组的(33.41±4.08)mm Hg(P<0.05)。治疗后,观察组IL-6(9.62±3.26)ng/L、CRP(13.59±4.52)mg/L、TNF-α(12.82±3.26)ng/L低于对照组的(21.16±4.58)ng/L、(20.41±6.62)mg/L、(22.51±5.68)ng/L(P<0.05)。治疗后,观察组FT_(4)(15.58±0.74)pmol/L、FT_(3)(5.21±0.61)pmol/L高于对照组的(14.15±0.75)、(4.62±0.58)pmol/L(P<0.05)。结论无创正压通气联合支气管镜肺泡灌洗治疗肺部重症感染能促进患者血气指标和炎性因子水平得到改善,并调节甲状腺功能,有效控制感染的持续进展。
Objective To investigate the clinical effect of non-invasive positive pressure ventilation combined with bronchoscopic alveolar lavage to treat severe pulmonary infections.Methods 86 patients with severe pulmonary infections were selected to the study,and patients were randomly divided into the control group and the observation group by lottery method,each with 43 cases.The control group was treated with noninvasive positive pressure ventilation on the basis of the conventional basic protocol,while the observation group was treated with bronchoscopic alveolar lavage on the basis of the treatment of the control group.Patients in both groups were compared in terms of clinical efficacy,blood gas indicators[arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],and thyroid function indicators[free thyroxine(FT_(4)),free triiodothyronine(FT_(3))].Results The total effective rate of the observation group was 93.02%(40/43),which was higher than the control group's 72.09%(31/43)(P<0.05).After treatment,the observation group exhibited higher PaO_(2)(66.14±5.79)mm Hg(1 mm Hg=0.133 kPa)and SaO_(2)(97.34±1.58)%compared to the control group[(62.65±5.82)mm Hg and(95.06±1.44)%],while PaCO_(2)(30.27±4.16)mm Hg was lower than the control group's(33.41±4.08)mm Hg(P<0.05).After treatment,the observation group had IL-6 of(9.62±3.26)ng/L,CRP of(13.59±4.52)mg/L,and TNF-αof(12.82±3.26)ng/L,which were lower than those in the control group[(21.16±4.58)ng/L,(20.41±6.62)mg/L,and(22.51±5.68)ng/L](P<0.05).After treatment,the observation group had FT_(4) of(15.58±0.74)pmol/L and FT_(3) of(5.21±0.61)pmol/L,which were higher than those in the control group[(14.15±0.75)and(4.62±0.58)pmol/L](P<0.05).Conclusion Noninvasive positive pressure ventilation combined with bronchoscopic alveolar lavage in the treatment of severe pulmonary infection can promote the adjustment of blood gas indexes and inflammatory factors,and regulate thyroid function,effectively control the continuous progression of infection.
作者
胡斯明
石宝玉
张娟娟
HU Si-ming;SHI Bao-yu;ZHANG Juan-juan(Department of Respiratory and Critical Care Medicine,Suzhou Municipal Hospital,Suzhou 215000,China)
出处
《中国实用医药》
2026年第4期22-25,共4页
China Practical Medicine
关键词
重症肺部感染
无创正压通气
支气管镜
肺泡灌洗
甲状腺激素
炎性因子
Severe pulmonary infection
Non-invasive positive pressure ventilation
Bronchoscopic alveolar lavage
Alveolar lavage
Thyroid hormones
Inflammatory factor
