纤维支气管镜灌洗治疗对重症肺炎临床疗效及预后的影响
Clinical Analysis of Bronchofiberscope Lavage in the Treatment of Severe Pneumonia and Its Significance in Improving Prognosis
摘要: 目的：探讨纤维支气管镜灌洗治疗对重症肺炎疗效的影响。方法：选择2020年1月~2022年5月我院收治的60例重症肺炎患者作为研究对象，采取随机数字表法对患者进行分组，随机分为对照组与观察组各30例。对照组采取常规治疗，包括抗菌、祛痰及对症治疗。观察组在对照组基础上实施纤维支气管镜灌洗治疗，比较两组患者的总有效率、症状缓解时间、住院时间、血清炎症因子指标、动脉血气分析指标、不良反应发生率。结果：观察组的总有效率为96.67%，高于对照组80.00%；与对照组相比，观察组的咳嗽、咳痰、发热等症状缓解时间，以及住院时间均显著性减少。观察组的血清IL-6、CRP、PCT水平与对照组相比均更低。与治疗前相比，两组患者PaO2、SO2在治疗后均改善，两组原来PaCO2高的患者治疗后的PaCO2均降低；治疗后，观察组的PaO2、SO2均高于对照组(P < 0.05)，观察组的PaCO2低于对照组。不良反应发生率观察组与对照组比较，差异无统计学意义。结论：纤维支气管镜灌洗治疗可有效减轻患者炎症反应，控制肺部感染，改善患者动脉血气状况。疗效显著，且不良反应少，安全性良好。
Abstract: Objective: To explore the clinical effect of bronchofiberscope lavage on severe pneumonia. Methods: 60 patients with severe pneumonia admitted to our hospital from January 2019 to May 2021 were selected as research objects, and were randomly divided into a control group and observation group with 30 cases each. The control group received routine treatment, including antibiotics, expectorants, and symptomatic treatment. The observation group received fiberoptic bronchoscopic lavage in addition to the routine treatment. The overall effective rate, symptom relief time, length of hospital stay, serum inflammatory factor markers, arterial blood gas analysis indicators, and incidence of adverse reactions were compared between the two groups.. Results: The total effective rate of the observation group was 96.67%, which was higher than that of the control group (80.00%). The remission time of cough, expectoration and fever in the observation group was shorter than that in the control group, and the hospitalization time in the observation group was shorter than that in the control group. Compared with before treatment, the levels of serum IL-6, CRP and PCT in the two groups decreased after treatment. After treatment, the levels of serum IL-6, CRP and PCT in the observation group were lower than those in the control group. Compared with before treatment, PaO2 and SO2 in both groups increased after treatment, while PaCO2 decreased after treatment. After treatment, PaO2 and SO2 in the observation group were higher than those in the control group (P < 0.05), while PaCO2 in the observation group was lower than that in the control group. There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group. Conclusion: Bronchoscopic lavage can effectively reduce the inflammatory reaction of patients, control the pulmonary infection, improve the pulmonary ventilation function and arterial blood gas status of patients. It has an obvious curative effect, fewer adverse reactions and good safety.
文章引用：张清华, 曹晓璐. 纤维支气管镜灌洗治疗对重症肺炎临床疗效及预后的影响[J]. 临床医学进展, 2025, 15(11): 686-692. https://doi.org/10.12677/acm.2025.15113147

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