患者,男性,75岁.因"呕吐、腹泻2个月"入院.患者2个月前无明显诱因出现进食后呕吐,呕吐物主要为胃内容物,伴有反酸、烧心,上腹部阵发性隐痛,腹泻(3～5次/d,黄色稀水样便),外院完善结肠镜检查未见明显异常.查体:两侧面颊发红,局部皮肤毛细血管扩张.双肺呼吸音清,未闻及明显干湿啰音.心率106次/分,律不齐,第一心音强弱不等,各瓣膜听诊区未闻及明显杂音.腹部平坦,触软,上腹部压痛,无反跳痛,肝脾肋下未及,移动性浊音阴性,肠鸣音5次/分.入院后给予止泻、抑酸护胃、改善肠道菌群和营养支持等对症治疗,效果不佳,仍腹泻明显.

Objective To analyze the therapeutic effect of low molecular weight heparin combined with acetylcysteine in patients with idiopathic interstitial pneumonia. Methods Sixty patients with idiopathic interstitial pneumonia, who were admitted to the Department of Respiratory Medicine, Xincheng District, Zaozhuang Municipal Hospital from January 2018 to January 2021, were retrospectively selected as the study subjects, and divided into the study group and the conventional group according to diff erent treatment methods, with 30 patients in each group. Patients in the conventional group received conventional treatment combined with low molecular weight heparin, and on the basis of the routine group, the treatment regimen of the research group was given low molecular weight heparin injection combined with acetylcysteine tablets. The adverse study and therapeutic eff ects were compared between the study group and the conventional group. Serum collagen type Ⅲ, HRCT lesion score, 6min walking distance, arterial partial pressure of carbon dioxide( PaCO2), arterial partial pressure of oxygen( PaO2) forced vital capacity( FVC), fi rst second forced end-expiratory volume( FEV1), and FEV1/FVC were compared before and after treatment between the study group and the conventional group. Results The total eff ective rate of the study group was 96.67％, higher than that of the conventional group 70.00％( P＜0.05). The PaO2 of the study group was higher than that of the conventional group, while PaCO2 was lower than that of the conventional group( P＜0.05). After treatment, the HRCT lesion score and serum type Ⅲ collagen in the study group were lower than those in the conventional group, and the 6min walking distance was higher than that in the conventional group( P＜0.05). After treatment, patients in FEV、 FVC and FEV1/FVC group were higher than those in conventional group( P＜0.05). The incidence of adverse reactions was 3.33％ in the study group and 6.67％ in the conventional group( P＞0.05). Conclusion For patients with idiopathic interstitial pneumonia, low molecular weight heparin combined with acetylcysteine can eff ectively improve the therapeutic effect, lung function and arterial blood gas indicators of patients are significantly improved, which is worthy of wide application.

Objective:To investigate the effect of electronic bronchoscopy lavage combined with intravenous infusion of sodium neohouttuynia on patients with bronchiectasis complicated by infection.Methods:Sixty-eight patients with bronchiectasis complicated by infection admitted to Xincheng District Branch Hospital of Zaozhuang Municipal Hospital from July 2019 to September 2021 were selected and divided into control group (34 cases) and observation group (34 cases) according to random number table method. After admission, patients in the two groups were treated by conventional treatments such as phlegm-reducing, anti-inflammatory and oxygen inhalation. Patients in the control group were given intravenous injection of sodium Houttuynia cordata, and patients in the observation group were given electronic bronchoscopy lavage based on the treatment of the control group. Both groups were treated for 3 weeks continuously. The clinical efficacy, blood gas analysis index, regulatory immune index and inflammatory factor index of the two groups were compared before and after treatment.Results:The clinical effective rate of the observation group was 94.12% (32/34), higher than the 67.65% (23/34) of the control group ( P<0.05). After treatment, partial pressure of oxygen (PaO 2) level was increased in the two groups, and PaO 2 in the observation group was higher than that in the control group ( P<0.05), while partial pressure of carbon dioxide (PaCO 2) level was decreased in the two groups, and PaCO 2 in the observation group was lower than that in the control group ( P<0.05). After treatment, the levels of serum interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) in the two groups were decreased, and these indexes in the observation group were lower than those in the control group ( P<0.05). After treatment, levels of T helper cell 17 (TH17) and TH17/regulatory T cell (Treg) in the two groups were decreased, and these indexes in the observation group were lower than those in the control group ( P<0.05); while Treg level was increased, and Treg level in the observation group was higher than that in the control group ( P<0.05). Conclusions:Electronic bronchoscope lavage combined with intravenous drip of sodium neohouttuynia in the treatment of bronchiectasis complicated by infection can reduce the inflammatory response, improve the blood gas index level, regulate the immune response, and improve the treatment effect.