纤维支气管镜吸痰联合肺泡灌洗对慢阻肺伴重症肺炎患者的影响OA
Effects of Fiberoptic Bronchoscopy-Guided Sputum Suction Combined with Bronchoalveolar Lavage on Patients with Chronic Obstructive Pulmonary Disease Complicated by Severe Pneumonia
目的:评估纤维支气管镜(FOB)吸痰联合肺泡灌洗在慢性阻塞性肺疾病(COPD)合并重症肺炎患者中的临床效果,探讨其对血清炎症因子水平、肺功能改善及临床症状的影响.方法:选取 2023 年 1 月—2024 年 12 月沭阳中医院收治的 80 例COPD伴重症肺炎患者,按随机分组方法分为两组,每组各 40 例.研究组接受纤维支气管镜吸痰联合肺泡灌洗治疗,对照组接受常规抗感染、吸氧及祛痰治疗.治疗前后,分别检测两组的血清C反应蛋白(CRP)、降钙素原(PCT)及白细胞介素-6(IL-6)水平及肺功能[第一秒用力呼气容积(FEV1)、预计值百分比(FEV1%pred)和最大呼气中期流速(MEF25%～75%)]指标,并记录临床症状改善时间和住院天数.结果:治疗后,研究组血清CRP、PCT、IL-6 水平均明显低于对照组,差异有统计学意义(P<0.05);FEV1、FEV1%pred、MEF25%～75%较治疗前明显改善,且改善幅度优于对照组,差异有统计学意义(P<0.05).研究组住院时间及症状缓解时间均短于对照组,差异有统计学意义(P<0.05),总有效率高于对照组,差异有统计学意义(P<0.05).结论:在 COPD合并重症肺炎患者中,纤维支气管镜吸痰联合肺泡灌洗有助于缓解气道病理状态,减轻炎症负荷,改善肺功能表现,并对临床转归产生积极影响.
Objective:To evaluate the clinical efficacy of fiberoptic bronchoscopy-guided sputum suction combined with bronchoalveolar lavage in patients with chronic obstructive pulmonary disease(COPD)complicated by severe pneumonia,and to investigate its effects on serum inflammatory markers,pulmonary function,and clinical symptoms.Method:A total of 80 patients with COPD complicated by severe pneumonia who were admitted to Suyang Hospital of Traditional Chinese Medicine between January 2023 and December 2024 were enrolled and randomly assigned into two groups,with 40 patients in each group.The study group received bronchoscopic sputum suction combined with bronchoalveolar lavage,while the control group received conventional treatment including anti-infective therapy,oxygen supplementation,and expectorant therapy.Serum levels of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6),as well as pulmonary function indices[forced expiratory volume in one second(FEV1),percentage of predicted FEV1(FEV1%pred),and maximal mid-expiratory flow(MEF25%～75%)]were measured before and after treatment in both groups.In addition,the time to improvement of clinical symptoms and length of hospital stay were recorded.Result:After treatment,serum CRP,PCT,and IL-6 levels in the study group were significantly lower than those in the control group,with statistically significant difference(P<0.05).Pulmonary function indices(FEV1,FEV1%pred,and MEF25%～75%)showed significant improvement compared with baseline,with greater improvements observed in the study group than in the control group,with statistically significant difference(P<0.05).The length of hospital stay and time to symptom relief were shorter in the study group,with a statistically significant difference(P<0.05).The total effective rate was significantly higher than that of the control group,with a statistically significant difference(P<0.05).Conclusion:In patients with COPD complicated by severe pneumonia,bronchoscopic sputum suction combined with bronchoalveolar lavage can help alleviate airway pathological changes,reduce the inflammatory burden,improve pulmonary function,and exert a positive impact on clinical outcomes.
刘达
沭阳中医院 江苏 沭阳 223600
慢性阻塞性肺疾病重症肺炎纤维支气管镜肺泡灌洗炎性因子肺功能
Chronic obstructive pulmonary diseaseSevere pneumoniaFiberoptic bronchoscopyAlveolar lavageInflammatory factorsPulmonary function
《中外医学研究》 2026 (3)
8-11,15,5
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