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Effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia

机译:纤维支气管镜联合无创正压通气洗肺对重症肺炎合并COPD患者血气结果和全身状态的影响

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Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
机译:目的:探讨纤维支气管镜联合无创正压通气洗肺对慢性阻塞性肺病合并重症肺炎患者血气结果和全身状态的影响。方法:收集2015年11月至2017年4月在医院接受治疗的68例COPD合并重症肺炎的患者,进行回顾性分析,然后将其分为A组(n = 35)接受无创正压通气和B组(n = 33)通过纤维支气管镜联合无创正压通气进行肺灌洗。比较两组治疗前后动脉血气和血清指标水平的差异。结果:治疗前,两组之间的动脉血气指数水平以及炎症介质,应激激素和心肌酶谱指数的血清含量无统计学差异。治疗后,B组动脉血气指标PH和PaO2均高于A组;血清炎症介质HMGB1,PCT和hs-CRP含量均低于A组;血清应激激素Cor,AngⅠ和AngⅡ含量均低于A组。结论:纤维支气管镜联合无创正压通气洗肺可以有效地优化动脉血气水平,其血清心肌酶谱指标α-HBDH和cTn-Ⅰ含量均低于A组。 ,降低全身性炎症应激状态并保护COPD并发严重肺炎的患者的心肌功能。

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