纤维支气管镜灌洗与常规治疗对重症肺部感染合并肺不张的疗效分析  

Effect of bronchoalveolar lavage under bronchofibroscope on severe pulmonary infection complicated with pulmonary atelectasis

作　　者：管彩虹[1] 楼雅芳[1] 陈旭燕[1] 

机构地区：[1]浙江杭州市中医院,浙江杭州310007

出　　处：《中国内镜杂志》2014年第6期612-615,共4页China Journal of Endoscopy

摘　　要：目的探讨经纤维支气管镜(纤支镜)支气管肺泡灌洗局部注入抗生素治疗重症肺部感染合并肺不张患者的临床疗效。方法收集该院117例重症肺部感染并肺不张患者随机分为对照组58例全身应用抗生素对症治疗,观察组59例在全身应用抗生素治疗基础上采用经纤维支气管镜肺泡灌洗术治疗,对比两组患者治疗情况。结果治疗组患者的咳嗽时间、发热时间、肺部啰音消失时间、WBC恢复正常时间、X线恢复正常时间以及住院时间明显少于对照组,差异有显著性(P<0.05);观察组的PO2、PCO2和SaO2分别为(91.4±4.2)mmHg、(37.4±2.9)mmHg和(93.7±4.4)%,显著高于对照组的(81.7±3.5)mmHg、(45.7±2.8)mmHg和(89.6±3.8)%,差异有显著性(P<0.05);治疗组患者临床总有效为86.44%,显著高于对照组患者67.24%(P<0.05)。结论经纤支镜肺泡灌洗治疗重症肺炎并肺不张能够有效解除支气管阻塞,更快地改善症状,提高临床治愈率,具有临床应用推广价值。[ Objective ] To observe effect of bronchoalveolar lavage under bronchofibroscope on severe pul- monary infection complicated with pulmonary atelectasis. [ Methods ] A total of 117 cases with severe pulmonary in- fection complicated with pulmonary atelectasis were randomly divided into two groups： observation group with 59 cases and control group with 58 cases. All patients were treated by antibiotics and expectorant.Besides, patients in observation group were treated by sputum aspiration and bronchoalveolar lavage under bronchofibroscope; while pa- tients in control group were treated by routine sputum aspiration. [ Results ] The time of fever, coughing time, the re- covering time of WBC and X-ray,rales disappeared of patients in treatment group were shorter than control group （P〈0.05）, the change of blood oxygen partial pressure in treatment group was better than control group （P〈0.05）; the total effective ratio of treatment group was 86.44%, and the control group was 67.24%, the differences were statisti- cally significant between the two groups（P〈0.05）. [ Conclusion ] Bronchoalveolar lavage under bronchofibroscope can improve respiratory tract symptoms and ventilation function. It can increase cure rate and is effective treatment for pulmonary infection complicated with pulmonary ateleetasis.

关 键 词：纤维支气管镜 支气管肺泡灌洗 重症肺部感染 肺不张 

分 类 号：R655.3[医药卫生—外科学]