Clinical efficacy analysis of fiberoptic bronchoscopy combined with bronchoalveolar lavage and non-invasive ventilator in the treatment of chronic obstructive pulmonary disease complicated with severe pneumonia
纤维支气管镜肺泡灌洗联合无创呼吸机治疗慢性阻塞性肺疾病合并重症肺炎的临床效果分析

摘要

目的 纤维支气管镜肺泡灌洗联合无创呼吸机治疗慢性阻塞性肺疾病（COPD）合并重症肺炎的临床效果。方法 研究对象共100例，均为本院治疗的慢性阻塞性肺疾病合并重症肺炎患者，治疗时间在2022年5月-2023年4月。随机分组，对照组采用无创呼吸机治疗；观察组在对照组基础上联合纤维支气管镜肺泡灌洗治疗。结果 观察组的PaO₂、OI高于对照组，PaCO₂低于对照组，P＜0.05。观察组的WBC、CRP低于对照组，P＜0.05。观察组的FEV₁、FVC及FEV₁/FVC比值均显著高于对照组（P<0.05）。观察组的IL-6和TNF-α水平显著低于对照组（P<0.05）。结论 纤维支气管镜肺泡灌洗联合无创呼吸机治疗治疗COPD合并重症肺炎在改善血气指标和OI、减轻炎症反应方面可以获得良好的效果。

Abstract

Objective To evaluate the clinical efficacy of bronchoscopic alveolar lavage combined with non-invasive ventilation in the treatment of chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia.
Methods A total of 100 patients with COPD and severe pneumonia treated in our hospital from May 2022 to April 2023 were included. The patients were randomly divided into a control group and an observation group. The control group received non-invasive ventilation therapy, while the observation group received bronchoscopic alveolar lavage in addition to the control group's treatment.
Results The observation group showed higher PaO₂ and OI levels, and lower PaCO₂ levels than the control group (P<0.05). The observation group also exhibited lower WBC and CRP levels than the control group (P<0.05). The FEV₁, FVC, and FEV₁/FVC ratios in the observation group were significantly higher than those in the control group (P<0.05). Additionally, the IL-6 and TNF-α levels in the observation group were significantly lower than those in the control group (P<0.05).
Conclusion   Bronchoscopic alveolar lavage combined with non-invasive ventilation can effectively improve blood gas parameters and OI, as well as reduce inflammatory responses in the treatment of COPD complicated with severe pneumonia.