支气管肺泡灌洗治疗老年重症肺炎合并呼吸衰竭的临床疗效

目的观察支气管肺泡灌洗术辅助治疗老年重症肺炎合并呼吸衰竭的临床疗效。方法将入选的90例患者随机分为观察组(46例)与对照组(44例),观察组予常规治疗,对照组在此基础上加用支气管肺泡灌洗术3～5次,对比两组患者治疗后动脉血气分析指标及临床疗效。结果①治疗72 h后,两组患者ApacheⅡ评分、SaO2、PaO2、PaCO2等均明显改善,观察组改善情况优于对照组(P<0.05);②治疗10d后,观察组显效率(45.7%)与总体有效率(84.8%)均高于对照组(22.7%、65.9%)(P<0.05)。结论支气管肺泡灌洗治疗老年重症肺炎合并呼衰能明显改善临床疗效,降低有创通气比例与病死率。

Clinical observation on bronchoalveolar lavage in the treatment of elderly patients with severe pneumonia complicated with respiratory failure

Objective To observe the clinical effect of bronchoalveolar lavage（BAL） in the adjuvant treatment of elderly patients with severe pneumonia complicated with respiratory failure.Methods 90 patients were randomly divided into the observation group（46 cases） and the control group（44 cases）.All patients were given the conventional treatment,and the observation group was treated with 3~5 times of BAL additionally.The indexes of arterial blood gas analysis and the curative effect were compared between the two groups.Results ① 72-hour after the treatment,Apache Ⅱ score,and the levels of SaO2,PaO2,and PaCO2 were significantly improved in the two groups,and the improvement was more pronounced in the observation group than in the control group（P0.05）.② 10-day after the treatment,the significant efficiency and total efficiency was 45.7% and 84.8% in the observation group and 22.7% and 65.9% in the control group respectively（P0.05）.Conclusion BAL can significantly improve curative effect and reduce invasive ventilation rate and mortality in the adjuvant treatment of elderly patients with severe pneumonia complicated with respiratory failure.