经纤维支气管镜肺灌洗治疗早期肺创伤的临床评价

Effects of lung lavage by bronchoscopy in treatment of early pulmonary trauma

目的评价经纤维支气管镜(纤支镜)肺灌洗治疗早期肺创伤的临床疗效。方法选择符合标准的61例早期肺创伤住院患者,随机分为常规治疗组(A组,n=29)和灌洗治疗组(B组,n=32)。灌洗治疗组在常规治疗基础上,于第2、3天用制备灌洗液(沐舒坦60mg、地塞米松10mg、肾上腺素1mg、0.9%氯化钠250mL)进行灌洗治疗。两组分别于入院时和治疗后第5天行动脉血气分析、胸部X线、肺通气功能检查,并进行临床综合评定。结果灌洗组患者的肺活量(VC)、1s量(FEV1)及动脉血氧分压均较入院时明显改善(P<0.05),灌洗组较常规组显著改善(P<0.01)。与治疗前相比,常规治疗组总有效率65%,灌洗组总有效率88%,两组差异有显著性(P<0.01)。结论纤维支气管镜肺灌洗治疗早期肺创伤疗效确切、安全可靠,灌洗液配制简便,易于推广。

[Objective] To investigate the effects of lung lavage by bronchoscopy in the treatment of early pulmonary trauma, [Methods] 61 patients with early pulmonary trauma were recruited on general wards and randomly assigned to standard medical treatment group （group A, n =29） or early administration of lung lavage plus standard medical treatment group （group B, n =32）. Lung lavage was performed in the group B with lung lavage fluid （losolvan 60 mg, dexamethasone 10 mg, epinephrine 1 mg and 0.9% sodium chloride 250 mL） on the 2nd or 3rd day. Arterial blood gases, X-ray manifestations, respiratory function and comprehensive assessment of clinical data were observed before and on the 5th day after treatment. [Results] The levels of VC, FV1 and PO2 were elevated a little in group A and markedly in group B. Compared to pretreatment, the overall response rate was 66% in group A, 88% in group B and had statistically significant difference in the two groups （P 〈0.01）. [Conclusion] Lung lavage fluid is prepared easily. Lung lavage by bronchoscopy is a safe and effectual way and easy to popularize in the treatment of early pulmonary trauma.