内科

【摘要】目的探讨支气管镜肺灌洗治疗对稳定期慢性阻塞性肺疾病患者肺功能、动脉血气及血清血C反应蛋白(CRP)、降钙素原(PCT)水平的影响。方法选取2012年2月至2016年2月在白银市第一人民医院治疗的稳定期慢性阻塞性肺疾病患者69例为研究对象，按照自愿原则将患者分为对照组（36例）与观察组（33例）。对照组患者给予家庭氧疗、沙美特罗/氟替卡松治疗；观察组患者在对照组患者治疗的基础上，行气管镜肺灌洗术治疗。检测比较两组患者治疗（灌洗）前后血清CRP、PCT、动脉血氧分压（PO2）、动脉血二氧化碳分压（PCO2）、一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量的比值(FEV1/FVC)。结果观察组患者灌洗后2 d、灌洗后1个月，FEV1（%）、FEV1/FVC显著高于灌洗前以及对照组患者治疗后2 d、治疗后1个月（P＜0.05），PO2和PCO2分别显著高于和低于灌洗前以及对照组患者治疗后 2 d、治疗后1个月（P＜0.01）；血清PCT、CRP水平显著低于灌洗前以及对照组患者治疗后2d、治疗后1个月的水平（P＜0.01）。结论在给予家庭氧疗、沙美特罗/氟替卡松吸入治疗的基础上，对稳定期慢性阻塞性肺疾病患者进行支气管镜肺灌洗治疗，可以在一定程度上改善患者的肺功能，减轻患者的气道炎症和系统性炎症反应，缓解患者的临床症状，对延缓病情进展，延长生存期有一定的价值。

【Abstract】ObjectiveTo investigate the effect of fiberoptic bronchoscopy bronchoalveolar lavage on lung function, arterial blood gas, serum Creactive protein(CRP) and procalcitonin(PCT) in patients with stable chronic obstructive pulmonary disease. MethodsA total of 69 patients with stable chronic obstructive pulmonary disease treated in the first people′s Hospital of Baiyin city from February 2012 to February 2016 were enrolled, and were randomly divided into the control group ( 36 cases) and the observation group (33cases) according to the voluntary principle. The control group treated with home oxygen therapy and salmeterol/fluticasone, while the observation group received fiberoptic bronchoscopy bronchoalveolar lavage on the basis of the control group. The levels of serum CRP and PCT, PCO2 and PO2, FEV1% and FEV1/FVC in the two groups were detected before and after treatment, and the above indexes were compared between the two groups. ResultsAfter two days and one month of intervention, the levels of FEV1%, FEV1/FVC, PO2 in the observation group were significantly higher than those before intervention and the control group (P＜0.01), and the levels of serum CRP and PCT, PCO2 in the observation group were significantly lower than those before intervention and the control group (P＜0.01). ConclusionsOn the basis of home oxygen therapy and salmeterol/fluticasone, fiberoptic bronchoscopy bronchoalveolar lavage in the treatment of patients with chronic obstructive pulmonary disease can improve the pulmonary function, reduce the airway inflammation and systemic inflammation, alleviate clinical symptoms, and has some value in checking the progress of disease, prolonging the survival time.