| 韩大贺,郭 毅,陈 朝,孙晓璐,邵 丽.重症肺炎伴呼吸衰竭患者行机械通气
联合纤维支气管镜肺泡灌洗的效果分析[J].现代生物医学进展英文版,2025,(3):459-467. |
| 重症肺炎伴呼吸衰竭患者行机械通气
联合纤维支气管镜肺泡灌洗的效果分析 |
| Analysis of the Effect of Mechanical Ventilation Combined with Fiberoptic Bronchoscopy Bronchoalveolar Lavage in Patients with Severe Pneumonia and Respiratory Failure |
| Received:November 25, 2024 |
| DOI：10.13241/j.cnki.pmb.2025.03.008 |
| 中文关键词: 重症肺炎 呼吸衰竭 机械通气 纤维支气管镜肺泡灌洗 呼吸力学 肝肾功能 心肌酶谱 |
| 英文关键词: Severe pneumonia Respiratory failure Mechanical ventilation Fiberoptic bronchoscopy bronchoalveolar lavage Respiratory mechanics Liver and kidney function Myocardial enzyme spectrum |
| 基金项目:江苏省卫生健康委科研课题项目（Ym2023071） |
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| 中文摘要: |
| 摘要 目的：探讨重症肺炎（severe pneumonia, SP）伴呼吸衰竭（respiratory failure, RF）患者行机械通气联合纤维支气管镜肺泡灌洗的效果。方法：回顾性选取2021年1月到2024年11月收治的70例SP伴RF患者，依照治疗方案将其分为2组，将35例接受机械通气等常规治疗的患者分为常规组，将35例接受纤维支气管镜肺泡灌洗与机械通气等常规治疗的患者分为灌洗组。治疗2周后，比较两组临床疗效，治疗前后炎症因子辩护，病情严重程度，呼吸力学指标，并比较两组心肌酶谱、肝功能、肾功能指标变化。结果：灌洗组总有效率为91.43%，常规组为71.43%，灌洗组高于常规组（P＜0.05）；治疗后灌洗组CRP、WBC、PCT水平低于常规组与治疗前（P＜0.05）；治疗后灌洗组CPIS、APACHEⅡ评分低于常规组与治疗前（P＜0.05）；治疗后灌洗组CPIS、APACHEⅡ评分低于常规组与治疗前（P＜0.05）；治疗后灌洗组PIP、Raw水平低于常规组与治疗前，Cydn高于常规组与治疗前（P＜0.05）；治疗后灌洗组cTnI、CKMB、LDH、AST、ALT、BUN、SCr水平低于常规组与治疗前（P＜0.05）。结论：SP伴RF行机械通气联合纤维支气管镜肺泡灌洗治疗效果显著，可减轻炎症反应、病情严重程度，改善患者呼吸力学指标，并在不损伤心、肝、肾脏功能的前提下，调节脏器血流，减轻心、肝、肾脏功能损伤。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of mechanical ventilation combined with fiberoptic bronchoscopy bronchoalveolar lavage in patients with severe pneumonia (SP) and respiratory failure (RF). Methods: A retrospective study was conducted on 70 patients with SP and RF admitted from January 2021 to November 2024. According to the treatment plan, they were divided into two groups. 35 patients who received conventional treatments such as mechanical ventilation were divided into the conventional group, and 35 patients who received conventional treatments such as fiberoptic bronchoscopy bronchoalveolar lavage and mechanical ventilation were divided into the lavage group. After 2 weeks of treatment, the clinical efficacy of the two groups was compared, including the defense of inflammatory factors, severity of the disease, respiratory mechanics indicators, and changes in myocardial enzyme spectrum, liver function, and kidney function indicators before and Post-treatment. Results: The total effective rate of the lavage group was 91.43%, while that of the conventional group was 71.43%. The lavage group was higher than the conventional group (P<0.05); Post-treatment, the levels of CRP, WBC, and PCT in the lavage group were lower than those in the conventional group and pretherapy (P<0.05); Post-treatment, the CPIS and APACHE II scores in the lavage group were lower than those in the conventional group and pretherapy (P<0.05); Post-treatment, the CPIS and APACHE II scores in the lavage group were lower than those in the conventional group and pretherapy (P<0.05); Post-treatment, the PIP and Raw levels in the lavage group were lower than those in the conventional group and pretherapy, while the Cydn levels were higher than those in the conventional group and pretherapy (P<0.05); The levels of cTnI, CKMB, LDH, AST, ALT, BUN, and SCr in the post-treatment lavage group were lower than those in the conventional group and pretherapy (P<0.05). Conclusion: SP combined with RF mechanical ventilation and fiberoptic bronchoscopy bronchoalveolar lavage has significant therapeutic effects, which can reduce the inflammatory response of patients, alleviate the severity of the disease, improve respiratory mechanics indicators, and regulate organ blood flow without damaging heart, liver, and kidney function, thereby reducing heart, liver, and kidney function damage. |
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