Efficacy of bronchoalveolar lavage in the treatment of severe pneumonia complicated with respiratory failure and its influence on inflammatory factors and pulmonary function
Objective To explore the clinical effect of bronchoalveolar lavage in the treatment of severe pneumonia complicated with respiratory failure and its influence on inflammatory factors and pulmonary function.Methods A total of 60 patients with severe pneumonia and respiratory failure were divided into a control group and an observation group according to random number table method,with 30 cases in each group.The control group was treated with conventional treatment,and the observation group was treated with bronchoalveolar lavage on the basis of the control group.Both groups were compared in terms of clinical efficacy,duration of mechanical ventilation and intensive care unit(ICU)treatment,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],blood gas indicators[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),blood oxygen saturation(SaO2),oxygenation index(PaO2/FiO2)]and pulmonary function indicators[forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),and ratio of FEV1 to forced vital capacity(FEV1/FVC)]before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(90.00%vs 66.67%,P<0.05).The duration of mechanical ventilation and ICU treatment in the observation group were(6.29±1.67)and(8.52±2.53)d,which were shorter than(8.53±2.24)and(11.46±3.37)d in the control group(P<0.05).After treatment,the levels of CRP,TNF-α and IL-6 in both groups decreased;the observation group had CRP of(2.21±0.68)mg/L,TNF-α of(17.42±1.94)ng/L and IL-6 of(3.18±0.59)ng/L,which were lower than(4.43±1.12)mg/L,(24.59±2.85)ng/L and(5.45±0.84)ng/L in the control group(P<0.05).After treatment,the levels of PaO2,SaO2,PaO2/FiO2 in both groups increased significantly,while PaCO2 level decreased significantly;the PaO2,SaO2,and PaO2/FiO2 levels in the observation group were(92.58±9.68)mm Hg(1 mm Hg=0.133 kPa),(92.51±9.34)%and(316.63±30.87)mm Hg,which were higher than(79.47±8.53)mm Hg,(80.78±8.28)%and(267.73±25.68)mm Hg in the control group;and PaCO2 level of(31.51±3.25)mm Hg was lower than(40.85±4.13)mm Hg in the control group(P<0.05).After treatment,FEV1,PEF and FEV1/FVC levels increased in both groups;and the observation group had FEV1 of(3.11±0.27)L,PEF of(4.84±1.14)L/s and FEV1/FVC of(75.78±7.68)%,which were higher than(2.23±0.18)L,(3.47±0.84)L/s and(62.46±6.45)%in the control group(P<0.05).Conclusion Application of bronchoalveolar lavage in patients with severe pneumonia and respiratory failure can improve the curative effect,shorten the duration of mechanical ventilation,lower the level of inflammatory factors in patients,improve blood gas indicators,and enhance lung ventilatory function,which is worthy of promotion.
Severe pneumoniaRespiratory failureBronchoalveolar lavageClinical efficacyInflammatory factorsPulmonary function
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维普
