纤维支气管镜肺泡灌洗对重症呼吸机相关性肺炎患者血清炎症因子水平的影响

摘要

Objective To investigate the effect of bronchofibroscopic bronchoalveolar lavage on serum inflammatory cytokines in the patients with severe ventilator-associated pneumonia(VAP) .Methods 68 cases of severe VAP were divided into the control group and observation group according to the random number table method ,34 cases in each group .The control group used conventional alveolar lavage plus sputum suction treatment ,while the observation group adopted bronchofibroscopic bronchoalveolar lavage plus sputum suction treatment .The lung infection control time ,mechanical ventilation treatment time ,time of body temperature recovery to normal ,pulmonary infection score(CPIS) ,white blood cell(WBC) count ,respiratory function ,blood gas indexes and serum inflammatory factors levels were compared between the two groups .Results The lung infection control time ,mechanical ventilation treatment time ,recovery time of normal temperature ,blood gas indexes and serum inflammatory factors levels after treatment in the observation group were significantly superior to those in the control group (P＜0 .05) .Conclusion Bronchofibroscopic bronchoalveolar lavage can significantly improve the respiratory function and blood gas indexes ,reduces the serum inflammatory factors levels in the patients with severe VAP .%目的 探讨纤维支气管镜肺泡灌洗对重症呼吸机相关性肺炎(V A P)患者血清炎症因子水平的影响.方法 将68例重症V A P患者依据随机数字表法分为对照组和观察组,每组各34例.对照组采取常规肺泡灌洗联合吸痰治疗,观察组则采取纤维支气管镜肺泡灌洗联合吸痰治疗,比较两组肺部感染控制时间、机械通气治疗时间、体温恢复至正常时间、肺部感染评分(CPIS)、白细胞计数、呼吸功能、血气指标及血清炎症因子水平变化.结果 观察组治疗后肺部感染控制时间、机械通气治疗时间、体温恢复至正常时间、肺部感染评分(CPIS)、白细胞计数、呼吸功能、血气指标及血清炎症因子水平均明显优于对照组(P<0.05).结论 纤维支气管镜肺泡灌洗可明显改善重症VAP患者呼吸功和血气指标,降低血清炎症因子水平.