支气管肺泡灌洗结合病灶局部注药对严重肺部感染合并呼吸衰竭的治疗作用  

Bronchoalveolar lavage plus localized infusions of drugs in management of patients of severe lung infections complicated with respiratory failure.

作　　者：茅尧生[1] 金烈洲[1] 应利君[1] 周蕾[1] 屠欣[1] 邢海波[1] 莫美娟[1] 

机构地区：[1]浙江大学医学院绍兴第一教学医院重症监护中心,312000

出　　处：《医师进修杂志》2005年第8期17-19,22,共4页Journal of Postgraduates of Medicine

摘　　要：目的探讨支气管肺泡灌洗(BAL)结合病灶局部注药对严重肺部感染的临床疗效。方法将69例进行机械通气治疗的严重肺部感染的患者随机分为对照组(综合治疗34例)和BAL组(35例)。治疗后对患者的临床症状、体征、相关实验室检查项目、肺部炎性病变吸收情况、呼吸机辅助控制模式应用时间、机械通气时间、ICU住院时间、APACHEⅢ评分和临床疗效进行分析。结果BAL组上述各项临床指标和APACHEⅢ评分均较对照组明显改善(P<0.01)。BAL组治愈率65.7%;对照组38.2%(P<0.05)。结论纤支镜经Y型套管导管进镜,可不中断呼吸机治疗,安全可靠。本方法疗效显著,简便易用,值得临床推广应用。Objective To explore the therapy effect of bronchoalveolar lavage （BAL） connected with local medication on severe lung infections complicated with respiratory failure. Methods Sixty - nine patients of severe lung infections complicated with respiratory failure were randomly divided into control group （34 patients） and BAL group （35 patients）. They were analysed, including clinical symptom, sign, the relevant indexes of laboratory examinations,conditions of the lung inflammation absorption,the applying time of A/C model, the mechanical ventilation, the hospitalization days of being in department of ICU, scores of APACHE Ⅲ and　the clinical effect after treatment. Results BAL group were improved significantly compared with the control group（ P 〈 0.01 ） by all the indexes mentioned above and the scores of APACHE Ⅲ. The cure rate in BAL group was 65.7%,while control group was 38.2 % （P〈0.05）. Conclusions It is safe and reliable to use branchofiberescope through Y model tube by branchofiberoscope, and the mechanical ventilation is not interrupted. Therefore, the method is efficient, convenient and worth promoting.

关 键 词：支气管肺泡灌洗 病灶注药 肺部感染 呼吸衰竭 地塞米松 

分 类 号：R563[医药卫生—呼吸系统] R974[医药卫生—内科学]