纤维支气管镜下治疗慢性阻塞性肺疾病急性发作合并严重肺部感染的效果

Fiberoptic bronchoscopy as a treatment in acute exacerbation of chronic obstructive pulmonary disease complicated with severe pulmonary infection

目的：探讨纤维支气管镜下治疗慢性阻塞性肺疾病急性发作（AECOPD）合并严重肺部感染的效果。方法：收集本院38例AECOPD合并严重肺部感染患者，分为观察组（20例）和对照组（18例），观察组在抗感染、营养支持等治疗基础上运用纤维支气管镜吸痰、药物灌洗，而对照组只给予常规抗感染、平喘、化痰、止咳治疗，观察两组治疗前后患者呼吸频率、心率、血气分析及胸部x线的变化以评定纤维支气管镜的辅助治疗的效果。结果：研究组显效13例，有效5例，无效2例，总有效率为90％（18／20）。对照组显效8例，有效4例，无效6例，总有效率66．7％（12／18），差异有统计学意义（P〉0．05）。结论：应用纤维支气管镜治疗AECOPD合并严重肺部感染的患者是安全有效的方法。

Objective：To investigate the efficacy of fiberoptic bronchoscopy in treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with severe pulmonary infection. Methods： 38 AECOPD in-patients complicated with severe pulmonary infection were divided into study group （n = 20） and control group （n = 18）. The study group received bronchoscopic suction of sputum and drug irrigation in addition to anti- infection therapy and nutrition support, while the control group only received routine antibiotics, anti-asthmatics, expectorants and antitussives. Before and after treatment, respiratory rate, heart rate, blood gas analysis and chest X ray were recorded of the both groups to assess the clinical efficacy of fiberoptie bronehoscopy. Results： The treatments turned out to be excellent in 13 cases, effective in 5 and ineffective in 2 cases of the study group [ total rate of response： 90% （18/20）J ,vs 8,4 and 6 cases in the control group [total rate of response： 66.7% ]. The difference between two groups was statistically significant （ P 〈 0.05 ）. Conclusion ： Fiberoptie bronchoseopy may be a safe and effective treatment among AECOPD patients complicated with severe pulmonary infection.