纤维支气管镜辅助治疗对老年重症呼吸机相关肺炎呼吸力学及血清炎症因子的影响

发布时间：2019-02-28 21:11

【摘要】：目的探讨纤维支气管镜辅助治疗对老年重症呼吸机相关性肺炎患者的呼吸力学及血清炎症因子的影响。方法 80例重症呼吸机相关性肺炎患者根据随机数字表法分为观察组和对照组各40例,对照组采用西医常规治疗,观察组在西医常规治疗基础上采用纤维支气管镜辅助治疗,比较两组治疗后的疗效指标,分析治疗前后呼吸力学指标及血清炎症因子的差异。结果治疗后观察组机械通气时间、肺部感染控制时间、呼吸系统加强护理病房(RICU)停留时间及治愈时间均明显低于对照组(P0.05)。治疗后两组动态顺应性(Cdyn)水平高于治疗前,而气道阻力(Raw)、气道峰压(PIP)及呼吸做功(WOB)水平低于治疗前,且观察组优于对照组(P0.05)。治疗后两组肿瘤坏死因子(TNF)-α、白细胞介素(IL)-4和IL-8低于治疗前,且观察组显著低于对照组(P0.05)。结论纤维支气管镜辅助治疗老年重症呼吸机相关性肺炎临床效果显著,可能与改善患者呼吸力学指标,降低血清炎症因子表达水平有关。
[Abstract]:Objective to investigate the effects of fiberoptic bronchoscopy on respiratory mechanics and serum inflammatory factors in elderly patients with severe ventilator-associated pneumonia. Methods 80 patients with severe ventilator-associated pneumonia were randomly divided into observation group (n = 40) and control group (n = 40). Compare the curative effect index of two groups after treatment, analyze the difference of respiratory mechanics index and serum inflammatory factor before and after treatment. Results after treatment, the mechanical ventilation time, the control time of pulmonary infection, the stay time of (RICU) and the time of cure were significantly lower in the observation group than those in the control group (P0.05). After treatment, the dynamic compliance (Cdyn) level in the two groups was higher than that before treatment, while the peak airway pressure (PIP) and respiratory work (WOB) level of airway resistance (Raw), in the two groups were lower than those before treatment, and the observation group was superior to the control group (P0.05). After treatment, the levels of tumor necrosis factor-伪 (TNF)-伪), interleukin-4 (IL)-4) and interleukin-4 (IL-8) in the two groups were significantly lower than those in the control group (P0.05). Conclusion the clinical effect of fiberoptic bronchoscopy in the treatment of elderly patients with severe ventilator-associated pneumonia is significant, which may be related to the improvement of respiratory mechanical indexes and the reduction of serum inflammatory factor expression.
【作者单位】：即墨市中医医院;
【分类号】：R563.1

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