床旁纤维支气管镜辅助治疗卒中相关性肺炎的疗效  

The effect of bedside fibrous bronchscope auxiliary treatment for stroke associated pneumonia

作　　者：韩秋[1] 李靖[1] 沈军[1] 曹向阳[1] 陈强[1] 邹文卫[1] 杨光[1] 

机构地区：[1]徐州医学院附属淮安市第二人民医院神经内科,淮安市223002

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第3期323-326,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨床旁纤维支气管镜吸痰及肺泡灌洗在卒中相关性肺炎患者诊疗过程中的疗效。方法随机将60例卒中相关性肺炎患者分为对照组和试验组,每组患者各30例,其中对照组采用常规吸痰及抗感染等治疗;试验组采用纤维支气管镜吸痰及肺泡灌洗。对患者进行连续肺部感染评分。比较两组患者治疗后血气结果、血清炎症因子水平以及肺部感染评分情况。结果试验组患者冶疗后血气分析结果(pH:7.41±0.04和7.15±0.11,t=2.280、P=0.035;PaCO_2:6.70±1.41 kPa和11.42±1.86 kPa,t=6.290、P=0.000;PaO_2:10.33±1.42 kPa和5.77±2.01 kPa,t=5.320、P=0.000)、血清炎症因子(CRP:95.86±42.35 mg/L和131.47±33.53 mg/L;PCT:3.27±1.12 ng/ml和7.57±1.46 ng/ml;IL-6:63.52±13.68 ng/L和94.47±21.34 ng/L;TNF-α:35.41±8.42 ng/L和54.62±11.57 ng/L;P均<0.01)、临床肺部感染评分(第3天:4.0±1.1分和4.5±1.3分,t=2.180、P=0.045;第7天:2.8±1.0分和3.4±1.2分,t=2.690、P=0.009)等指标均显著优于对照组患者。结论床边纤维支气管镜吸痰及肺泡灌洗安全、有效,具有很高的应用价值,特别适用于卒中相关性肺炎的患者。Objective To investigate the effect of bedside fibrous bronchscope suction and alveolar lavage in patients with stroke associated pneumonia（SAP）. Methods Total of 60 patients with stroke associated pneumonia were randomly divided into control group and experimental group, each group with 30 cases. The patients in control group were given treatement of sputum sucking and antibiotic drugs. Sputum sucking was replaced with bedside fibrous bronchscope suction and alveolar lavage in experimental group. The blood gas, serum levels of inflammatory factors and clinical pulmonary infection score of two groups were compared, respectively. Results The results of blood gas（pH： 7.41 ± 0.04 and 7.15 ± 0.11, t = 2.280, P = 0.035; PaCO2： 6.70 ± 1.41 kPa and 11.42 ± 1.86 kPa, t = 6.290, P = 0.000; PaO2： 10.33 ± 1.42 kPa and 5.77 ± 2.01 kPa, t = 5.320, P = 0.000）, serum inflammatory factors（CRP： 95.86 ± 42.35 mg/L and 131.47 ± 33.53 mg/L; PCT： 3.27 ± 1.12 ng/ml and 7.57 ± 1.46 ng/ml; IL-6： 63.52 ± 13.68 ng/L and 94.47 ± 21.34 ng/L; TNF-α： 35.41 ± 8.42 ng/L and 54.62 ± 11.57 ng/L, P all 0.01） and clinical pulmonary infection score（the third day： 4.0 ± 1.1 and 4.5 ± 1.3, t = 2.180, P = 0.045; the senventh day： 2.8 ± 1.0 and 3.4 ± 1.2, t = 2.690, P = 0.009） in experimental group were significantly superior to those in control group. Conclusions Bedside fibrous bronchoscope suction combined with alveolar lavage is a safe and effective method for treatment of SAP. It has high clinical value, and is worth application in clinic.

关 键 词：床旁纤维支气管镜 肺泡灌洗 卒中相关性肺炎 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R563.1[医药卫生—临床医学]