摘要
目的探讨纤维支气管镜(纤支镜)吸痰和灌洗后注药术对胸部外科手术后肺部感染的治疗作用。方法分析51例经积极常规治疗无效,肺部感染加重合并肺不张、呼吸衰竭的术后病人,在监护条件下行纤支镜吸痰和灌洗后注药,选用无菌生理盐水(37℃)作为灌洗液和稀释液,阿米卡星(丁胺卡那霉素)气管内给药,观测临床症状、体征和胸部X线改变。结果51例行纤支镜吸痰和灌洗后注药治疗,并指导抗生素应用,7d内显效44例,有效6例,无效1例,总有效率98%。吸取的分泌物培养出致病菌有38例,病菌分离率75%,但原病人咯出痰的痰培养只有8例阳性,病菌分离率15.8%。无严重并发症发生。结论胸外术后肺部感染病人使用纤支镜治疗,有助于确定致病菌,较彻底清除大气道分泌物,改善肺通气功能,局部给药提高病灶内药物浓度,增强抗菌效果,无不良反应。
[Objective] To probe curative effects of amikacin given after drawing spittoon by bronchofiberscopy and bronchoalveolar lavage in treating the patients complicating pulmonary infection after thoracic operations.[Methods] First, 51 patients were drawn spittoon by bronchofiberscopy. Then, the bronchoalveolar lavage was carried out with aseptic normal saline (37℃). Last, amikacin and a little aseptic normal saline given by bronchofiberscopy. To observe the clinical symptoms, body signs and X-ray changes. [Results] The treatment cured 50 patients in a short time. [Conclusions] The treatment possesses the advantages that are to helpfully find pathogenic bacteria and clear away secretion in the tracheas, better local anti-inflammatory actions. Its curative effects are confirmed and there are not harmful reactions to be found.
出处
《中国内镜杂志》
CSCD
北大核心
2005年第7期724-725,共2页
China Journal of Endoscopy
关键词
纤维支气管镜
支气管肺部灌洗
肺部感染
治疗
bronchofiberscopy
bronchoalveolar lavage
pulmonary infection
treatment