纤维支气管镜灌洗对重症肺部感染患者的疗效  

Effect of fiberoptic bronchoscopy lavage on treatment of patients with severe pulmonary infections

作　　者：曾建明[1] 曾春芳[1] 冯银合 甘春艳 杨俊勇 

机构地区：[1]德阳市人民医院呼吸内科,四川德阳618000 [2]新疆胸科医院内镜室,新疆乌鲁木齐830000

出　　处：《中华医院感染学杂志》2016年第6期1303-1305,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅重点基金资助项目(201228283)

摘　　要：目的研讨纤维支气管镜灌洗对重症肺部感染患者的疗效及预后影响,为降低医院感染提供依据。方法选择2012年9月-2015年9月于医院接受治疗的重症肺部感染患者114例进行研究;根据数字法将患者随机分为观察组及对照组,各57例,对照组患者给予常规治疗,观察组在此基础上另予以纤维支气管镜灌洗治疗;治疗7d后对比两组患者疗效、住院相关指标、治疗后不同时间的体征指标,分析观察组患者的不良反应。结果患者总有效率观察组为94.74%,对照组为82.46%,差异有统计学意义(P<0.05);观察组患者体温恢复正常、肺部湿啰音消失时间及住院时间均少于对照组,差异有统计学意义(P<0.05);观察组治疗第7天的体温及白细胞计数均分别低于对照组,差异有统计学意义(P<0.05);观察组患者在治疗过程中有11例发生窦性心动过速同时血氧饱和度降低,5例患者发生严重紫绀同时血氧饱和度降低。结论利用纤维支气管镜灌洗对发生重症肺部感染的患者进行治疗具有较好的疗效,且有助于改善患者的预后。OBJECTIVE To observe the effect of fiberoptic bronchoscopy lavage on treatment of patients with severe pulmonary infections and analyze the impact on prognosis so as to reduce the incidence of nosocomial infections.METHODS A total of 114 patients with severe pulmonary infections who were treated in hospitals from Sep 2012 to Sep 2015 were enrolled in the study and randomly divided into the observation group and the control group,with 57 cases in each.The control group was given the conventional treatment,while the observation group was treated with additional fiberoptic bronchoscopy lavage based on the conventional treatment.The clinical efficacy,hospitalization-related indicators,and clinical sings were observed and compared between the two groups after the treatment for 7days,and the incidence of adverse reactions was analyzed.RESULTS The total effective rate of the observation group was 94.74%,the control group 82.46%,and there was significant difference（P0.05）.The time of recovery of body temperature,time of disappearance of pulmonary rales,and length of hospital stay were significantly shorter in the observation group than in the control group（P0.05）.The body temperature and white blood cell counts of the observation group were respectively lower than those of the control group on Day 7of treatment（P0.05）.In the observation group,there were 11 patients with sinus tachycardia with concurrent reduction of blood oxygen saturation and 5patients with severe cyanosis complicated with decreased blood oxygen saturation during the treatment.CONCLUSIONThe fiberoptic bronchoscopy lavage can achieve significant effect on treatment of the patients with severe pulmonary infections and contribute to the improvement of prognosis.

关 键 词：纤维支气管镜灌洗 重症肺部感染 疗效 预后影响 

分 类 号：R563.1[医药卫生—呼吸系统]