昆明医科大学学报2024，Vol.45Issue(5)：151-156,6.DOI:10.12259/j.issn.2095-610X.S20240523
支气管肺泡灌洗复合低分子肝素对重症肺炎患者的影响
The Effect of Bronchoalveolar Lavage Combined with Low Molecular Weight Heparin on Patients with Severe Pneumonia
摘要
Abstract
Objective To analyze the effect of bronchoalveolar lavage combined with low molecular weight heparin on the prognosis with prone ventilation due severe pneumonia.Methods 102 patients with the severe pneumonia from hospitals from January 2021 to January 2023 were selected as the study subjects and randomly divided into a control group(51 cases,conventional treatment+low molecular weight heparin)and a study group(51 cases,conventional treatment+low molecular weight heparin+bronchoalveolar lavage)using a random number table method.Blood gas indexes[blood oxygen saturation(SaO2),partial arterial oxygen pressure(PaO2),partial arterial carbon dioxide pressure(PaCO2)],respiratory dynamics indexes[respiratory work done(WOB),airway resistance(Raw),dynamic compliance(Cdyn)],pulmonary function indexes[forced vital capacity(FVC),1 second maximum expiratory volume(FEV1),maximum expiratory flow rate(PEF)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)],and D-dimer levels before and the first week of treatment were compared between the two groups.And the incidence of adverse prognosis(death,ICU admission,intubation and invasive ventilator)was calculated in the two groups.Results After one week of the treatment,the levels of SaO2 and PaO2 in the study group were higher than those in the control group,while PaCO2 was lower than those in the control group(t=4.649,3.774,4.792,P<0.05);After one week of the treatment,the WOB and Raw levels in the study group were lower than those in the control group,while the Cdyn levels were higher than those in the control group(t=7.207,5.401,3.150,P<0.05);After one week of the treatment,the FVC,FEV1,and PEF in the study group were higher than those in the control group(t=3.834,3.960,3.908,P<0.05);After one week of the treatment,the study group had TNF-α、The levels of IL-6,IL-8,and D-dimer in the control group were lower than those in the control group(t=5.642、5.002、6.712、4.127,P<0.05);The incidence of poor prognosis in the study group was lower than that in the control group(χ2=4.547,P<0.05).Conclusion Bronchoalveolar lavage,combined with low molecular weight heparin,can shorten the duration of clinical symptom disappearance and hospital stay,improve the blood gas indexes,respiratory dynamics,enhance lung function and reduce the level of inflammatory factors in patients with severe pneumonia.关键词
重症肺炎/俯卧位通气/支气管肺泡灌洗/低分子肝素/病情转归Key words
Severe pneumonia/Prone position ventilation/Bronchoalveolar lavage/Low molecular weight heparin/Disease outcome分类
医药卫生引用本文复制引用
曾阳,王茜,田茂良..支气管肺泡灌洗复合低分子肝素对重症肺炎患者的影响[J].昆明医科大学学报,2024,45(5):151-156,6.基金项目
四川医学科研计划基金资助项目(S19046) （S19046）
