目的 探究纤维支气管镜肺泡灌洗术治疗老年重症肺炎的临床效果.方法 选取2022-03～12月作者医院收治的107例老年重症肺炎患者为研究对象.根据是否采用纤维支气管镜肺泡灌洗术进行治疗分为观察组(n=54)和对照组(n=53).对照组老年重症肺炎患者给予抗感染治疗、糖皮质激素抗炎治疗、祛痰平喘吸氧等对症支持治疗.观察组老年重症肺炎患者在对照组治疗的基础上联合纤维支气管镜肺泡灌洗治疗.比较两组老年重症肺炎患者治疗前后血气分析结果、炎症因子水平、住院情况及临床疗效.结果 两组老年重症肺炎患者治疗前一般资料比较,差异无统计学意义(P＞0.05).治疗前,两组老年重症肺炎患者血氧分压(partial pressure of blood oxygen,PaO2)、二氧化碳分压(partial pressure of blood carbon dioxide,PaCO2)、血氧饱和度(oxyhemoglobin saturation,SaO2)水平,C 反应蛋白(C-re-active protein,CRP)、降钙素原(procalcitonin,PCT)、白细胞计数(white blood cell,WBC)水平,组间比较差异无统计学意义(P＞0.05).治疗后,两组老年重症肺炎患者PaO2、SaO2水平明显升高,且观察组高于对照组(P均＜0.001);两组老年重症肺炎患者PaCO2水平,CRP、PCT、WBC水平明显降低,且观察组低于对照组(P均＜0.001).观察组老年重症肺炎患者体温恢复时间、胸部电子计算机断层扫描(computed tomography,CT)好转时间、抗菌药物使用时间以及总住院时间均短于对照组,临床治疗总有效率显著高于对照组,组间比较差异均具有统计学意义(P均＜0.001).结论 在常规抗感染治疗基础上联合纤维支气管镜肺泡灌洗治疗老年重症肺炎,能有效改善患者血气指标、降低炎症反应并促进机体康复,具有临床治愈率高、临床治疗效果佳的特点.
Clinical Efficacy of Fiberoptic Bronchoscopy Lung Lavage in Treating Patients with Senile Severe Pneumonia
Objective To investigate the clinical effects of fiberoptic bronchoscopy lung lavage in the treatment of senile severe pneumonia.Methods A total of 107 patients with senile severe pneumonia admitted to author's department from March to December 2022 were selected as the research subjects.The patients were divided into observation group(n=54)and control group(n=53)according to whether fiberoptic bronchoscopy lung lavage was used for treatment.The patients with senile severe pneumonia in the control group were given anti-infection treatment,glucocorticoid anti-inflam-matory treatment,expectorant and asthma oxygen inhalation and other symptomatic and supportive treatments.The pa-tients with senile severe pneumonia in the observation group was treated with fiberoptic bronchoscopy lung lavage on the basis of the treatment of the control group.The blood gas analysis results,inflammatory factor levels,hospitalization and clinical efficacy of patients with senile severe pneumonia were compared between the two groups before and after treat-ments.Results There was no significant difference in general data between the two groups before treatments(P＞0.05).Before the treatments,partial pressure of blood oxygen(PaO2)level,partial pressure of blood carbon dioxide(PaCO2)level,oxyhemoglobin saturation(SaO2)level,C-reactive protein(CRP)level,procalcitonin(PCT)level and white blood cell(WBC)level in the patients with senile severe pneumonia between two groups had no significant differ-ence(P＞0.05).After treatments,the levels of PaO2 and SaO2 in the two groups significantly increased,and those in the observation group were higher than those in the control group(all P＜0.001);the levels of PaCO2,CRP,PCT and WBC in the two groups significantly decreased,and those in the observation group were lower than those in the control group(all P＜0.001).The body temperature re-covery time,improvement time of the chest computed tomography(CT),antibacterial drug usage time and total hospitali-zation time of the observation group were shorter than those of the control group,and the total effective rate of clinical treatment was significantly higher than that of the control group,and the differences between the two groups were statis-tically significant(all P＜0.001).Conclusion On the basis of conventional anti-infection treatment,fiberoptic bronchos-copy lung lavage in the treatment of patients with senile severe pneumonia can effectively improve the blood gas index,re-duce the inflammatory response and promote the recovery of the body with high clinical cure rate and good clinical treat-ment effect.
Fiberoptic bronchoscopy lung lavageSenile severe pneumoniaBlood gas indexInflammatory factorClinical efficacy
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