纤维支气管镜肺灌洗对ICU机械通气合并肺部感染患者降钙素原和C反应蛋白的影响研究

摘要

Objective To investigate the effect of bronchoalveolar lavage via fiberoptic bronchoscopy on procalcitonin (PCT)and C - reactive protein(CRP)of pulmonary infection patients with mechanical ventilation in Critical Care Unit(ICU). Methods 88 pulmonary infection patients with mechanical ventilation in ICU were selected as study subjects by using the purposive sampling method. These patients were adimtted to Yixing Peopleˊs Hospital Affiliated to Jiangsu University from January 2013 to January 2014. These patients were divided into two groups equally:bronchoalveolar lavage via fiberoptic bronchoscopy group(observation group)and conventional sputum suction therapy group( control group),PCT and CRP of patients in observation group and control group were measured before treatment and 7 d after treatment,and the efficacy was compared between the two groups. Results The effective rate for observation group and control group was 93. 2% (41 / 44)and 81. 8%(36 / 44),respectively,there was significant difference in effective rate between the two groups( χ2 = 8. 641,P ﹤ 0. 05). There was significant difference in infection level 7 d after treatment between the two groups(Z = - 2. 879,P ﹤ 0. 05). The CRP level 7 d after treatment of patients in observation group was significantly lower than that in control group(t = - 48. 792,P﹤0. 05). For both groups,the CRP level 7 d after treatment was significantly lower than that before treatment( t = 27. 839, 24. 049,P ﹤0. 05). Conclusion The bronchoalveolar lavage via fiberoptic bronchoscopy for pulmonary infection patients with mechanical ventilation in ICU can effectively reduce levels of PCT and CRP,and it is of benefit to pulmonary infection control.%目的：探讨纤维支气管镜肺灌洗对 ICU 机械通气合并肺部感染患者血清降钙素原（PCT）以及 C 反应蛋白（CRP）的影响。方法采用目的抽样法选取2013年1月—2014年1月于江苏大学附属宜兴市人民医院 ICU 住院的机械通气合并肺部感染患者88例为研究对象，按其入 ICU 顺序及病种特点等分为纤维支气管镜肺灌洗组（观察组）及常规吸痰组（对照组），各44例，检测治疗前及治疗7 d 时观察组和对照组患者 PCT、CRP 水平，比较两组治疗效果。结果观察组有效率为93.2％（41/44），对照组有效率为81.8％（36/44），差异有统计学意义（χ2＝8.641，P﹤0.05）。观察组治疗7 d 时感染程度与对照组比较，差异有统计学意义（Z ＝-2.879，P ﹤0.05）。观察组治疗7 d 时CRP 水平低于对照组（ t ＝-48.792，P ﹤0.05）。观察组及对照组治疗7 d 时 CRP 水平均低于治疗前（ t ＝27.839、24.049，P ﹤0.05）。结论 ICU 机械通气合并肺部感染患者行纤维支气管镜肺灌洗可有效降低其 PCT、CRP 水平，对控制肺部感染起积极作用。