支气管肺泡灌洗乙酰半胱氨酸联合布地奈德 治疗老年人重症肺炎的研究

Effect of Bronchoalveolar Lavage with Acetylcysteine Combined with Budesonide in the Treatment of Severe Pneumonia in the Elderly

摘要:

〔摘 要〕 目的：探讨支气管肺泡灌洗乙酰半胱氨酸联合布地奈德雾化治疗老年人重症肺炎的疗效。 方法：选取上饶市 人民医院于 2021 年 1 月至 2022 年 10 月收治的 65 例老年重症肺炎患者作为研究对象，根据治疗方法不同分为对照组和观 察组，其中对照组 30 例，观察组 35 例。对照组治疗方式为在常规治疗基础上进行支气管肺泡灌洗 0.9 % 氯化钠注射液治疗， 观察组治疗方式为在常规治疗基础上使用支气管肺泡灌洗乙酰半胱氨酸联合布地奈德雾化治疗。比较两组患者临床疗效、 临床指标、炎症指标、肺功能。 结果：观察组患者临床总有效率高于对照组，差异具有统计学意义（P ＜ 0.05）。观察组 患者退烧时间、咳痰消失时间、咳嗽消失时间、肺啰音消失时间及住院时间均短于对照组，差异具有统计学意义（P ＜ 0.05）。 治疗后，观察组患者外周血白细胞（WBC）计数，血清 C 反应蛋白（CRP）、降钙素原（PCT）水平低于对照组，差异具 有统计学意义（P ＜ 0.05）。治疗后，观察组患者用力肺活量（FVC）、第 1 秒用力呼气量（FEV1）、FEV1/FVC 高于对照组， 差异具有统计学意义（P ＜ 0.05）。 结论：支气管肺泡灌洗乙酰半胱氨酸联合布地奈德雾化治疗老年重症肺炎患者疗效确切， 可以明显缩短治疗时间，改善机体炎症反应及肺功能。

Abstract:

〔Abstract〕 Objective To investigate the effect of bronchoalveolar lavage with acetylcysteine combined with budesonide nebulization in the treatment of severe pneumonia in the elderly. Methods A total of 65 elderly patients with severe pneumonia who were admitted to Shangrao People's Hospital from January 2021 to October 2022 were selected as the research subjects. They were divided into a control group (30 cases) and an observation group (35 cases) according to different treatment methods. The control group received bronchoalveolar lavage with 0.9 % sodium chloride injection on the basis of conventional treatment, while the observation group received bronchoalveolar lavage with acetylcysteine combined with budesonide nebulization on the basis of conventional treatment. The clinical efficacy, clinical indicators, inflammatory indicators, and pulmonary function in the two groups were compared. Results The total clinical effective rate of the observation group was higher than that of the control group (P < 0.05). The fever abatement time, time for expectoration, cough and lung rales disappearing, and length of hospital stay in the observation group were shorter than those in the control group (P < 0.05). After treatment, peripheral blood white blood cells (WBC) count, the serum levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group (P < 0.05). After treatment, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and FEV1/ FVC in the observation group were higher than those in the control group (P < 0.05). Conclusion Bronchoalveolar lavage with acetylcysteine combined with budesonide nebulization is effective in the treatment of severe pneumonia in the elderly. The combined treatment can significantly shorten the treatment time, relieve inflammatory response and improve pulmonary function.