The Effect of Bronchoscopic Lavage Combined with Antibiotic De-escalation Therapy on Pulmonary Function and Inflammatory Status in Patients with Severe Pulmonary Infection

ZHOU Lei; ZHANG Hua

doi:10.14033/j.cnki.cfmr.2024.33.007

Abstract：Objective:To investigate the effect of bronchoscopic lavage combined with antibiotic descending step therapy on lung function and inflammation in patients with severe pulmonary infection.Method:84 patients with severe pulmonary infection admitted to Taizhou Fourth People's Hospital from August 2022 to August 2023 were selected as the study objects and divided into control group and study group according to different treatment methods,with 42 cases in each group.Both groups were given basic symptomatic treatment,the control group was given antibiotic descending staircase therapy,and the study group was given fiberoptic bronchoscopic lavage treatment on the basis of antibiotic descending staircase therapy.Lung function[total lung volume(TLC),maximum volume of air volume(MMV),1 s forced expiratory volume(FEV1)],blood gas indicators[partial pressure of arterial oxygen(PaO2),partial pressure of arterial carbon dioxide(PaCO2),and saturation of arterial oxygen(SaO2)],inflammatory status[interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT)],symptom resolution time(cough resolution,lung rales resolution,fever resolution time)were compared between the two groups.Result:After intervention,TLC,MMV and FEV1 in the study group were higher than those in the control group,and the difference was statistically significant(P＜0.05).After the intervention,PaCO2 of the study group was lower than that of the control group,moreover PaO2 and SaO2 were higher than that of the control group,and the difference was statistically significant(P＜0.05).After intervention,IL-6,PCT and hs-CRP in the study group were lower than those in the control group,and the difference was statistically significant(P＜0.05).After intervention,the disappearance time of cough,lung rales and fever in the study group was shorter than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion:Fiberbronchoscopic lavage combined with antibiotic step-down therapy can improve lung function and blood gas indexes in patients with severe pulmonary infection,reduce the level of inflammation,and accelerate the disappearance of symptoms.