阿米卡星肺泡灌洗联合纤维支气管镜技术在重症肺部感染患者治疗中的应用  

Amikacin Alveolar Lavage Combined with Fiberoptic Bronchoscopy Technique in the Treatment of Patients with Severe Pulmonary Infections

作　　者：魏捷飞 冯磊 吴大伟 WEI Jiefei;FENG Lei;WU Dawei(Respiratory and Critical Care Ward 2,the Second People’s Hospital of Nanyang,Nanyang,473000,China;Department of Neurosurgery,the Second People’s Hospital of Nanyang,Nanyang,473000,China)

机构地区：[1]南阳市第二人民医院呼吸与危重症二病区,河南南阳473000 [2]南阳市第二人民医院神经外科,河南南阳473000

出　　处：《湖北民族大学学报（医学版）》2024年第2期48-52,共5页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察重症肺部感染患者行阿米卡星肺泡灌洗联合纤维支气管镜技术时患者的整体获益水平。方法采取随机数表法将南阳市第二人民医院2023年1月-2023年12月收治的100例重症肺部感染患者分为对照组(50例,常规治疗+阿米卡星注射液静滴)与研究组(50例,阿米卡星肺泡灌洗联合纤维支气管镜技术),对比治疗2周后的治疗效果、血气指标[动脉二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、动脉氧分压(PaO_(2))]、肺功能[最大通气量(MMV)、最大呼气中期流量(MMEF)功能残气量(FRC)]、炎症指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、SP蛋白(SP-D)、降钙素原(PCT)]、肺部感染评分及不良反应。结果与对照组相比,研究组治疗总有效率明显更高(χ2=8.036,P<0.05);治疗结束时,两组PaCO_(2)下降,PaO_(2)、SaO_(2)升高,研究组PaCO_(2)较低,PaO_(2)、SaO_(2)较高(P<0.05);两组FRC、MMV、MMEF均升高,且研究组FRC、MMV、MMEF明显高于对照组(P<0.05);两组PCT、hs-CRP、TNF-α、SP-D表达均下降,且研究组PCT、hs-CRP、TNF-α、SP-D明显更低(P<0.05);治疗结束时两组肺部感染评分均下降,且研究组低于对照组(P<0.05)。结论重症肺部感染患者应用阿米卡星肺泡灌洗联合纤维支气管镜技术,治疗效果显著,利于改善患者血气及肺功能,缓解炎症状态与肺部感染程度,且安全性理想,可在临床重症肺部感染患者治疗中应用。Objective To observe the overall level of patient benefit when amikacin alveolar lavage combined with fiberoptic bronchoscopy technique was performed in patients with severe pulmonary infections.Methods A random number table was used to divide 100 patients with severe pulmonary infections admitted to our hospital from January_(2)023 to December_(2)023 into a control group(50 patients,conventional treatment+Amikacin injection intravenous drip)and a study group(50 patients,amikacin alveolar lavage combined with fiberoptic bronchoscopy technique).The blood gas indexes[arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SaO_(2)),arterial partial pressure of oxygen(PaO_(2))],pulmonary function[maximum ventilation volume(MMV),maximum mid-expiratory flow(MMEF)functional residual air volume(FRC)],inflammation indexes[ultrasensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),SP protein(SP-D),calcitoninogen(PCT)],lung infection score and adverse effects were compared.Results Compared with the control group,the total effective rate of treatment was high and the overall treatment effect was superior in the study group(P<0.05).At the end of treatment,the PaCO_(2) decreased and PaO_(2) and SaO_(2) increased in both groups,and the PaCO_(2) was lower and PaO_(2) and SaO_(2) were higher in the study group(P<0.05).The FRC,MMV,and MMEF were elevated in both groups,and the FRC,MMV,and MMEF were higher in the study group(P<0.05).The PCT,hs-CRP,TNF-α,and SP-D expression decreased in both groups,and the PCT,hs-CRP,TNF-α,and SP-D were lower in the study group(P<0.05).Lung infection scores decreased in both groups at the end of treatment,and were lower in the study group than those in the control group(P<0.05).Conclusion The application of amikacin alveolar lavage combined with fiberoptic bronchoscopy in patients with severe pulmonary infections has significant therapeutic effects,facilitates the improvement of patients’blood gas and lung function,alleviates the inflammatory state and the de

关 键 词：重症肺部感染 阿米卡星 肺泡灌洗 纤维支气管镜技术 

分 类 号：R563.1[医药卫生—呼吸系统]