电子支气管镜在老年肺部感染中的应用价值分析  

Value of Electronic Bronchoscopy in the Elderly Patients with Pulmonary Infection

作　　者：王永[1] 张晓梅[1] 翟娜[1] Wang Yong Zhang Xiaomei Zhai Na(Department of Respiratary, Xinyi Railroad Hospital, Xinyi 221400, China)

机构地区：[1]江苏省新沂市铁路医院呼吸科,中国新沂221400

出　　处：《国际老年医学杂志》2016年第6期253-257,共5页International Journal of Geriatrics

摘　　要：目的：探讨电子支气管镜（EBS）冲洗加局部用药治疗老年肺部感染的临床疗效.方法：2012年1月～2015年6月新沂市铁路医院收治的122例老年肺部感染患者按就诊顺序单双号随机分为观察组和对照组,每组61例.两组患者均给予常规综合治疗,包括：吸氧、解痉平喘、止咳化痰、能量支持、纠正水电酸碱失衡,根据痰培养＋药物敏感试验结果选择敏感抗生素.观察组加用EBS治疗,使用氨溴索15 mg稀释后反复冲洗,直至管腔通畅,选择敏感抗生素稀释后注入病变部位并保留,每周治疗2～3次.两组疗程均为10d.结果：①观察组痊愈率为37.7％ （23/61）,显效率为41.0％（25/61）,对照组痊愈率为24.6％ （15/61）,显效率为32.8％ （20/61）,观察组临床疗效明显优于对照组（u=2.353,P=0.019）;②两组治疗后pH值、PaO2水平均明显升高,PaCO2、hs-CRP、PCT水平均明显下降,观察组改善比对照组更明显（P＜0.01）;③观察组治疗后pH值、PaO2水平均明显升高,PaCO2、hs-CRP、PCT水平明显下降,与治疗前对比差异均有统计学意义（P＜0.01）;④观察组住院天数、住院费用及抗生素使用天数均低于对照组（P＜0.01或P＜0.05）.结论：EBS冲洗加局部用药治疗老年肺部感染可以提高临床疗效,升高pH值、PaO2水平,降低PaCO2、hs-CRP、PCT水平,缩短住院天数、抗生素使用天数,降低住院费用.OBJECTIVE： To investigate the clinical effect of electronic bronchoscopy （EBS） and local medication in the treat- ment of elderly patients with pulmonary infection. METHODS： From January 2012 to June 2015 in Xinyi Railway Hospital 122 elderly patients with lung infection were randomly divided into observation group （n = 80） and control group （n = 60）. Two groups were giv- en conventional treatment, including oxygen, spasmolysis, relieving cough and phlegm, energy support, correct electrolyte imbal- ances, according to sputum culture mad drug sensitivity test findings sensitive to the choice of antibiotics. The observation group was added with EBS. RESULTS： （1）The cure rate in observation group was 37. 7% （23/61） and the efficient rate in the observation group was 41% （25/61）. The cure rate in the control group was 24. 6% （15/61） and the clinical efficient rate was 32. 8% （20/61）. The clinical efficacy in the observation group was significantly better than that in the control group （u = 2. 353, P =0. 019） ; （2）After treat- ment the levels of pH and PaO2 were significantly increased in the two groups, and the levels of hs - CRP, PCT and PaCO2 were sig- nificantly decreased, which in the observation group was significantly higher than that in control group （P 〈 0. 01 ） ; （3）After treat- ment, the levels of pH and PaO2 were significantly increased, the levels of PaCO2 , hs - CRP and PCT were significantly decreased. And there were statistically significant differences （ P 〈 0. 01 ） ; （4）The hospitalization days, hospitalization expenses and the use of antibiotics in the observation group were lower than those in the control group （ P 〈 0.01 or P 〈 0. 05 ）. CONCLUSION ： EBS washing and local treatment of pulmonary infection in the elderly can improve the clinical efficacy, increase pH and PaO2 level, lower hs - CRP, PCT, PaCO2 levels, shorten the length of hospital stay, antibiotics use days, and reduce hospitalization expenses.

关 键 词：电子支气管镜 肺部感染 老年 疗效 

分 类 号：R452[医药卫生—治疗学]