美罗培南联合地塞米松经纤维支气管镜灌洗治疗大面积烧伤并肺部感染的临床效果  

Clinical effects of bronchoalveolar lavage with meropenem and dexamethasone via fiberoptic bronchoscopy in treatment of extensive burns with pulmonary infection

作　　者：谷慧英 Gu Huiying(Department of Respiratory Medicine,the Fourth People’s Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]河南省商丘市第四人民医院呼吸科,476000

出　　处：《中国实用医刊》2022年第2期109-112,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨美罗培南联合地塞米松经纤维支气管镜灌洗治疗大面积烧伤并肺部感染的临床效果。方法:抽取2019年6月至2021年6月商丘市第四人民医院收治的大面积烧伤并肺部感染患者90例,按照随机数表法分为观察组和对照组,每组45例。对照组采用常规治疗,观察组在常规治疗基础上采用美罗培南联合地塞米松经纤支镜灌洗治疗。记录受试者控制感染时间、不良反应发生情况,以及动脉血气分析指标、血液学指标、呼吸力学指标变化。结果:治疗后,观察组控制感染时间为(10.36±1.29)d,低于对照组的(13.85±1.47)d( P<0.05);观察组动脉血二氧化碳分压(PaCO 2)、钙素原( PCT)、白细胞计数( WBC)、C-反应蛋白( CRP)水平分别为(40.02±3.98)mmHg(1 mmHg=0.133 kPa)、(1.78±0.52)ng/L、(8.52±1.08)×10 9/L、(14.36±3.11)mg/L,低于对照组的(42.46±4.25)mmHg、(3.59±1.53)ng/L、(10.47±1.46)×10 9/L、(20.38±4.62)mg/L( P<0.05);观察组的pH、动脉血氧分压(PaO 2)水平为(7.35±0.11)、(76.23±7.14)mmHg,高于对照组的(7.28±0.15)、(71.46±7.42)mmHg( P<0.05);治疗后,观察组呼吸做功(WOB)水平为(0.26±0.12)J/L,低于对照组的(0.64±0.31)J/L,动态顺应性(Cdyn)水平为(37.18±7.13)cmH 2O(1 cmH 2O=0.098 kPa),高于对照组的(26.41±6.27)cmH 2O( P<0.05)。两组治疗期间均未出现明显不良反应。 结论:采用美罗培南联合地塞米松经纤支镜灌洗能有效治疗大面积烧伤并肺部感染患者,能缩短控制感染时间,提高患者肺功能,降低炎性因子水平。Objective To investigate the clinical effects of bronchoalveolar lavage with meropenem and dexamethasone via fiberoptic bronchoscopy in treatment of extensive burns with pulmonary infection.Method A total of 90 patients with extensive burns and pulmonary infection admitted to the Fourth People’s Hospital of Shangqiu were enrolled from June 2019 to June 2021.According to random number table method,they were divided into observation group and control group,45 cases in each group.The control group underwent routine therapy,while the observation group underwent fiberoptic bronchoscopic lavage with meropenem and dexamethasone.The infection control time,occurrence of adverse reactions,changes in levels of arterial blood gas analysis indexes,hematology index and respiratory mechanics indexes were recorded.Results After treatment,the infection control time in the observation group was(10.36±1.29)d,which was lower than that in the control group(13.85±1.47)d(P<0.05);the levels of arterial blood carbon dioxide partial pressure(PaCO2),procalcitonin(PCT),leukocyte count(WBC)and C-reactive protein(CRP)in the observation group were(40.02±3.98)mmHg(1 mmHg=0.133 kPa),(1.78±0.52)ng/L and(8.52±1.08)×109/L,(14.36±3.11)mg/L,which were lower than(42.46±4.25)mmHg,(3.59±1.53)ng/L,(10.47±1.46)×109/L,(20.38±4.62)mg/L in the control group(P<0.05);the levels of pH and arterial blood oxygen partial pressure(PaO2)in the observation group were(7.35±0.11),(76.23±7.14)mmHg,which were higher than those in the control group(7.28±0.15),(71.46±7.42)mmHg(P<0.05);after treatment,the level of work of breathing(WOB)in the observation group was(0.26±0.12)J/L,which was lower than(0.64±0.31)J/L in the control group,and the level of lung dynamic compliance(Cdyn)was(37.18±7.13)cmH2O(1 cmH2O=0.098 kPa),which was higher than(26.41±6.27)cmH2O in the control group(P<0.05).Conclusions The application of fiberoptic bronchoscopic lavage with meropenem and dexamethasone can effectively treat patients with extensive burns and pulmonary infection

关 键 词：烧伤 美罗培南 地塞米松 肺部感染 纤维支气管镜 

分 类 号：R644[医药卫生—外科学] R563.1[医药卫生—临床医学]