纤维支气管镜吸痰辅助治疗对重症肺部感染患者的疗效及炎症标志物水平的影响分析

发布时间：2018-05-24 13:20

本文选题：纤维支气管镜 + 辅助治疗　；参考：《中华医院感染学杂志》2017年22期

【摘要】：目的分析纤维支气管镜吸痰辅助治疗对重症肺部感染患者的疗效及炎症标志物水平的影响,为临床抗感染治疗工作提供客观依据。方法选取2015年9月-2016年9月的重症肺部感染患者102例作为研究对象,根据治疗方式将其分为两组,应用纤维支气管镜吸痰联合常规抗感染治疗的58例患者设为试验组,仅应用常规抗感染治疗的44例患者设为对照组,观察两组患者的临床疗效,比较两组患者体温恢复正常时间、血象恢复正常时间、肺部症状消失时间、机械通气时间、住院时间等治疗指标,比较两组患者治疗前后的血清脂联素(APN)、降钙素原(PCT)、巨噬细胞炎症蛋白-1α(MIP-1α)等炎症标志物水平,比较两组患者治疗前后的血管紧张素转换酶(ACE)、一氧化氮(NO)、胆碱酯酶(ChE)等病情严重程度标志物。结果试验组的临床有效率为87.9%高于对照组的63.6%,疗效分布优于对照组,两组比较差异有统计学意义(P0.05);试验组患者的体温恢复正常时间、血象恢复正常时间、肺部症状消失时间、机械通气时间、住院时间等治疗指标均低于对照组,两组比较差异均有统计学意义(P0.05);试验组患者治疗后血清PCT、MIP-1α水平显著低于对照组,血清APN水平显著高于对照组,两组比较差异均有统计学意义(P0.05);试验组患者治疗后的血清ACE、NO水平显著低于对照组,血清ChE水平显著高于对照组,两组比较差异均有统计学意义(P0.05)。结论在重症肺部感染中应用纤维支气管镜吸痰进行辅助治疗,能够提高治疗效果、改善治疗指标、降低全身性炎症反应程度和疾病严重程度,有利于提高救治成功率和改善患者预后。
[Abstract]:Objective to analyze the effect of bronchofiberscope sputum aspiration on severe pulmonary infection and the level of inflammatory markers in order to provide an objective basis for clinical anti-infection therapy. Methods 102 patients with severe pulmonary infection from September 2015 to September 2016 were selected and divided into two groups according to the treatment methods. 58 patients who were treated with fiberoptic bronchoscopy combined with routine anti-infection therapy were divided into two groups. 44 patients who were treated with routine antiinfective therapy were set up as control group. The clinical efficacy of the two groups was observed. The time of temperature recovery, blood image recovery, lung symptom disappearance and mechanical ventilation were compared between the two groups. The levels of serum adiponectin (APN), procalcitonin (PCT), macrophage inflammatory protein (1 伪) and MIP-1 伪) were compared between the two groups before and after treatment. The severity markers of angiotensin converting enzyme (ACEN), nitric oxide (no) and cholinesterase (che) were compared between the two groups before and after treatment. Results the clinical effective rate of the trial group was 87.9% higher than that of the control group (63.6%), and the distribution of the curative effect was better than that of the control group, and the difference between the two groups was statistically significant (P 0.05). The time of mechanical ventilation and the duration of hospitalization were lower than those of the control group, and the difference between the two groups was statistically significant (P 0.05), the levels of serum PCT TnMIP-1 伪 and APN in the experimental group were significantly lower than those in the control group, and the level of serum APN was significantly higher than that in the control group. The level of serum ACEN was significantly lower and the level of serum ChE was significantly higher in the experimental group than that in the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion the application of bronchofiberscope in the treatment of severe pulmonary infection can improve the therapeutic effect, improve the treatment index and reduce the degree of systemic inflammation and the severity of the disease. It is beneficial to improve the success rate of treatment and improve the prognosis of patients.
【作者单位】：大庆龙南医院呼吸内科;
【基金】：黑龙江省医学科研基金资助项目(A2010244)
【分类号】：R563.1

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