纤维支气管镜灌洗与常规治疗对重症肺部 感染合并肺不张的疗效分析

Effect of bronchoalveolar lavage under bronchofibroscope on severe pulmonary infection complicated with pulmonary atelectasis

摘要:

目的 探讨经纤维支气管镜（纤支镜）支气管肺泡灌洗局部注入抗生素治疗重症肺部感染合并肺不张患者的临床疗效。方法 收集该院117例重症肺部感染并肺不张患者随机分为对照组58例全身应用抗生素对症治疗，观察组59例在全身应用抗生素治疗基础上采用经纤维支气管镜肺泡灌洗术治疗，对比两组患者治疗情况。结果 治疗组患者的咳嗽时间、发热时间、肺部啰音消失时间、WBC恢复正常时间、X线恢复正常时间以及住院时间明显少于对照组，差异有显著性（P <0.05）；观察组的PO2、PCO2和SaO2分别为（91.4±4.2）mmHg、（37.4±2.9）mmHg和（93.7±4.4）%，显著高于对照组的（81.7±3.5）mmHg、（45.7±2.8）mmHg和（89.6±3.8）%，差异有显著性（P <0.05）；治疗组患者临床总有效为86.44%，显著高于对照组患者67.24%（P <0.05）。结论 经纤支镜肺泡灌洗治疗重症肺炎并肺不张能够有效解除支气管阻塞，更快地改善症状，提高临床治愈率，具有临床应用推广价值。

Abstract:

【Objective】 To observe effect of bronchoalveolar lavage under bronchofibroscope on severe pulmonary infection complicated with pulmonary atelectasis. 【Methods】 A total of 117 cases with severe pulmonary infection complicated with pulmonary atelectasis were randomly divided into two groups: observation group with 59 cases and control group with 58 cases. All patients were treated by antibiotics and expectorant.Besides, patients in observation group were treated by sputum aspiration and bronchoalveolar lavage under bronchofibroscope; while patients in control group were treated by routine sputum aspiration. 【Results】 The time of fever, coughing time, the recovering time of WBC and X-ray,rales disappeared of patients in treatment group were shorter than control group (P＜0.05), the change of blood oxygen partial pressure in treatment group was better than control group(P＜0.05); the total effective ratio of treatment group was 86.44%, and the control group was 67.24%, the differences were statistically significant between the two groups(P＜0.05). 【Conclusion】 Bronchoalveolar lavage under bronchofibroscope can improve respiratory tract symptoms and ventilation function. It can increase cure rate and is effective treatment for pulmonary infection complicated with pulmonary atelectasis.