纤维支气管镜灌洗联合经鼻高流量湿化氧疗对重症肺炎合并呼吸衰竭患者动脉血气、呼吸功能及炎性因子水平的影响
Effects of bronchoscopic lavage combined with nasal high-flow humidifying oxygen therapy on arterial blood gas,respiratory function and inflammatory factors in patients with severe pneumonia complicated with respiratory failure
宋欣欣 1王岚 1李闪闪 1杨亚旭1
作者信息
- 1. 河南科技大学第一附属医院呼吸与危重症医学科,河南 郑州 471000
- 折叠
摘要
目的 探讨重症肺炎合并呼吸衰竭患者应用纤维支气管镜灌洗联合经鼻高流量湿化氧疗(HFNC)对动脉血气、呼吸功能及炎性因子水平的影响.方法 择取我院2021年9月至2023年9月期间116例重症肺炎合并呼吸衰竭患者为研究对象,以随机数表法均分为2组.基础组58例给予HFNC,研究组58例增加纤维支气管镜灌洗.对比两组患者临床疗效、动脉血气、呼吸功能、炎性因子水平.结果 研究组总有效率高于基础组(P＜0.05);研究组患者动脉血氧分压(PaO2)、血氧饱和度(SpO2)水平均高于基础组,动脉血二氧化碳分压(PaCO2)水平低于基础组;研究组患者最大吸气压实测与预测比值(MIP％)、最大呼气压实测与预测比值(MEP％)水平均高于基础组,气道阻力(AR)、气道峰压(PAP)水平均低于基础组(P＜0.05);研究组患者肿瘤坏死因子-a(TNF-a)、C反应蛋白(CRP)、白细胞介素-10(IL-10)水平均低于基础组(P＜0.05).结论 纤维支气管镜灌洗联合(HFNC)能够有效改善重症肺炎合并呼吸衰竭患者动脉血气及呼吸功能,减轻炎症反应,提高疗效.
Abstract
Objective To investigate the effects of bronchoscopic lavage combined with nasal high flow humidifying oxygen therapy(HFNC)on arterial blood gas,respiratory function and inflam-matory factors in patients with severe pneumonia complicated with respiratory failure.Methods 116 patients with severe pneumonia combined with respiratory failure in our hospital from Sep-tember 2021 to September 2023 were selected as research objects and divided into 2 groups by random number table method.In the basic group,58 patients were given HFNC,and in the study group,58 patients were given bronchoscopic lavage.The clinical efficacy,arterial blood gas,respiratory function and inflammatory factors were compared between the two groups.Re-sults:The total effective rate of study group was higher than that of basic group(P＜0.05).The level of PaO2 and SpO2 in the study group was higher than that in the basic group,and the level of PaCO2 was lower than that in the basic group.The measured and predicted ratio of maxi-mum inspiratory pressure(MIP％)and measured and predicted ratio of maximum expiratory pressure(MEP％)in study group were higher than those in basic group,and the levels of airway resistance(AR)and airway peak pressure(PAP)were lower than those in basic group(P＜0.05).The levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-10(IL-10)in study group were lower than those in basic group(P＜0.05).Conclusion Fiber-bronchoscopic lavage combined with HFNC can effectively improve arterial blood gas and respira-tory function in patients with severe pneumonia complicated with respiratory failure,reduce in-flammation and improve therapeutic effect.
关键词
纤维支气管镜灌洗/经鼻高流量湿化氧疗/重症肺炎/呼吸衰竭Key words
bronchofiberscope lavage/Nasal high flow humidified oxygen therapy/Severe pneu-monia/Respiratory failure引用本文复制引用
基金项目
洛阳市医疗卫生指导性科技计划(2022)(2022056Y)
出版年
2024
NETL
NSTL
维普
万方数据