关键词:

肺部感染, 呼吸衰竭, 机械通气, 乌司他丁, 炎症介质, 肺功能

Abstract:

Objective To analyze the clinical value of ulinastatin combined with bronchoalveolar lavage （BAL）in patients undergoing mechanical ventilation due to respiratory failure caused by pulmonary infection. Methods A total of 117 patients with respiratory failure caused by pulmonary infection who underwent mechanical ventilation in ICU of the First Affilicated Hospital of Zhengzhou University between January 2017 and June 2020 were divided into observation group（BAL combined with ulinastatin，n = 58）and control group（BAL，n = 59） according to treatment method. The levels of peripheral blood inflammatory factors，lung function indexes，blood gas indexes，adverse reactions and prognosis were compared between the two groups. Results After treatment，the levels of peripheral blood tumor necrosis factor α（TNF⁃α），transforming growth factor⁃β1（TGF⁃β1）and C⁃reactive protein（CRP）were reduced in the two groups，and the levels in observation group were lower than those in the control group（P < 0.05）. After treatment，tidal peak expiratory flow（PTEF），ratio of VPEF to peak tidal expiratory flow and total expiratory time（VPTEF/VTE），ratio of time to peak tidal expiratory flow and total expiratory time （TPTEF/TE），the 50% tidal volume during expiratory flow（TEF50%）/PTEF and the 25% tidal volume during expi⁃ ratory flow（TEF25%）/PTEF were increased in the two groups，and the above indexes in observation group were higher than those in the control group（P < 0.05）. After treatment，oxygenation index（OI）and partial pressure of arterial oxygen（PaO2）were increased，and arterial partial pressure of carbon dioxide（PaCO2）was reduced in the two groups. The observation group had higher OI and PaO2，and lower PaCO2 than the control group. There was no signifi⁃ cant difference in expectoration volume or 28 d mortality between the two groups（P > 0.05）. The observation group had shorter mechanical ventilation time and hospital stay than the control group（P < 0.05）. Conclusion Ulina⁃ statin combined with BALF can effectively improve local inflammatory response and lung function，and optimize blood gas in patients undergoing mechanical ventilation due to respiratory failure caused by pulmonary infection

Key words:

pulmonary infection, respiratory failure, mechanical ventilation, ulinastatin, inflamma? tory factor, lung function