内科

目的探讨支气管镜肺灌洗对稳定期慢性阻塞性肺疾病患者的治疗价值以及安全性。方法选取2012年2月至2017年6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95例为研究对象，随机分为对照组（47例）与观察组（48例）。对照组患者给予家庭氧疗、沙美特罗/氟替卡松等治疗；观察组患者在对照组治疗的基础上，行气管镜肺灌洗术治疗。比较两组患者治疗(灌洗)前后血清CRP、PCT、动脉血气（PO2、PCO2）、肺功能（FEV1%、FEV1/FVC、MMEF25、MMEF50、MMEF75）、6 min步行距离（6MWT）、呼吸困难程度等的变化。结果治疗(灌洗)后2 d、治疗(灌洗)后1个月，观察组患者呼吸困难程度得分显著降低、6 min步行距离显著增加（P＜0.01），呼吸困难程度得分显著低于对照组、6 min步行距离显著大于对照组；观察组患者FEV1%、FEV1/FVC、MMEF25、MMEF50、MMEF75显著升高且显著高于对照组（P＜0.01）；观察组患者动脉血PO2水平显著升高、PCO2水平显著降低，PO2水平显著高于对照组、PCO2水平显著低于对照组（P＜0.01）；观察组患者血清PCT、CRP水平显著降低且显著低于对照组（P＜0.01）。结论应用支气管镜肺灌洗技术治疗稳定期慢性阻塞性肺疾病患者，可减轻患者的气道炎症和系统性炎症，改善患者的肺功能，缓解呼吸困难症状，提高运动耐力，安全可靠，值得推广应用。

ObjectiveTo investigate the efficacy and safety of bronchoscopic lung lavage in the treatment of patients with stable chronic obstructive pulmonary diseas. Methods95 patients with stable chronic obstructive pulmonary disease in Baiyin First People′s Hospital from February 2012 to June 2017 were selected and randomly divided into the control group (47 cases) and the observation group (48 cases). The control group were treated with family oxygen therapy, Shah Mette Lo/fluticasone, etc. The observation group were treated with bronchoscopic lung lavage on the basis of the control group. The changes of serum CRP and PCT, arterial blood gas (PO2 and PCO2), pulmonary function (FEV1%, FEV1/FVC, MMEF25, MMEF50, MMEF75), 6min walking distance (6MWT) and dyspnea were compared between the two groups before and after treatment. ResultsAfter 2D and 1 months after treatment, the scores of dyspnea in the observation group decreased significantly and the distance of 6min walking increased significantly (P＜0.01). The score of dyspnea degree was significantly lower than that of the control group and 6min walking distance was significantly higher than that of the control group. The FEV1%, FEV1/FVC, MMEF25, MMEF50 and MMEF75 in the observation group were significantly increased, and significantly higher than those in the control group (P＜0.01). The level of PO2 in the arterial blood and the level of PCO2 decreased significantly in the observation group, and the level of PO2 was significantly higher than that of the control group and the level of PCO2 was significantly lower than that of the control group (P＜0.01). The serum levels of PCT and CRP in the observation group were significantly lower and significantly lower than those in the control group (P＜0.01). ConclusionBronchoscopic lung lavage in the treatment of patients with stable chronic obstructive pulmonary disease can reduce airway inflammation and systemic inflammation, improve the lung function, relieve the symptoms of dyspnea, and improve the exercise endurance. It is safe and reliable, and it is worth popularizing and applying.