支气管肺泡灌洗痰热清注射液治疗危重患者多重耐药鲍曼不动杆菌肺炎的疗效分析  

Therapeutic Effect of Bronchoalveolar Lavage Tanreqing Injection (痰热清注射液) in the Treatment of Multidrug-resistant Acinetobacter Baumannii Pneumonia in Critical Ill Patients

作　　者：罗文娟[1] 王灿敏[1] 胡英芳[1] 叶敏宜 LUO Wen-juan;WANG Can-min;HU Ying-fang;YE Min-yi(Guangdong Second People's Hospital,Guangzhou Guangdong 513017,China)

机构地区：[1]广东省第二人民医院

出　　处：《中医药导报》2019年第11期95-98,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省中医药局科研项目(20162006)

摘　　要：目的:观察经纤维支气管镜(纤支镜)支气管肺泡灌洗痰热清注射液治疗危重患者多重耐药鲍曼不动杆菌(MDRAB)肺炎的疗效。方法:将64例MDRAB肺炎患者随机分成治疗组(32例)和对照组(32例),两组患者均给予亚胺培南西司他丁钠联合头孢哌酮钠舒巴坦钠抗感染等常规治疗,治疗组患者在常规治疗基础上给予纤支镜支气管肺泡灌洗痰热清注射液治疗,两组患者连续治疗14d。观察两组患者治疗前和治疗7d、14d的血白细胞计数(WBC)、C反应蛋白(CRP)、灌洗液IL-6水平及氧合指数水平,比较两组患者影像学检测的肺部病灶改善效果和细菌检测的MDRAB清除效果,观察不良反应情况。结果:两组患者治疗后血白细胞计数(WBC)、C反应蛋白(CRP)和灌洗液IL-6水平均降低(P<0.05),且治疗组患者治疗后血白细胞计数(WBC)、C反应蛋白(CRP)和灌洗液IL-6水平均低于对照组(P<0.05)。两组患者治疗后氧合指数均高于治疗前(P<0.05),且治疗组患者治疗后氧合指数高于对照组(P<0.05);治疗组影像学检测的肺部病灶改善有效率为78.13%,明显高于对照组(56.25%)(P<0.05);治疗组细菌检测的MDRAB清除率为71.88%,明显高于对照组(43.75%)(P<0.05);两组患者治疗过程中均未发生危及生命的严重并发症。结论:纤支镜支气管肺泡灌洗痰热清注射液能有效降低危重患者多重耐药鲍曼不动杆菌性肺炎的炎症指标水平,改善患者氧合功能,清除肺部鲍曼不动杆菌,促进肺部感染病灶吸收。Objective:To observe the efficacy of fiberoptic bronchoscope bronchoalveolar lavage Tanreqing injection in the treatment of multidrug-resistant acinetobacter baumannii(MDRAB)pneumonia in critically ill patients.Methods:A total of 64 patients with MDRAB pneumonia were randomly divided into the treatment group(32 cases)and the control group(32 cases).Both groups were treated with imipenem cilastatin sodium combined with cefoperazone sodium and sulbactam sodium for anti-infection.The patients in the treatment group were treated with bronchoalveolar lavage Tanreqing injection by bronchoscope on the basis of routine treatment.The two groups were treated for 14 days.The levels of WBC,CRP,IL-6 in lavage fluid and oxygenation index were observed before treatment and 7 d and 14 d after treatment.The improvement of pulmonary lesions detected by imaging and the removal of MDRAB by bacterial detection were compared between the two groups,and the adverse reactions were observed.Results:After treatment,the levels of WBC,CRP and IL-6 in lavage fluid were decreased in both groups(P<0.05),and the levels of WBC,CRP and IL-6 in lavage fluid in treatment group were lower than those in control group(P<0.05).After treatment,the oxygenation index of the two groups was higher than that before treatment(P<0.05),and the oxygenation index of the treatment group was higher than that of the control group(P<0.05).The effective rate of lung lesion improvement in the treatment group was 78.13%,which was significantly higher than that in the control group(56.25%)(P<0.05).The MDRAB clearance rate of the bacteria in the treatment group was 71.88%,which was significantly higher than that in the control group(43.75%)(P<0.05).There were no serious life-threatening complications in both groups.Conclusion:fiberoptic bronchoscope bronchoalveolar lavage Tanreqing injection can effectively reduce the level of inflammatory index of multi-drug resistant acinetobacter baumannii pneumonia in critically ill patients,improve the oxygenation function of patients

关 键 词：多重耐药鲍曼不动杆菌 肺炎 痰热清注射液 支气管肺泡灌洗 

分 类 号：R256.1[医药卫生—中医内科学]