支气管肺泡灌洗治疗老年肺部感染疗效观察

Effect of bronchoalveolar lavage on pneumonia in the elderly

目的:探讨支气管肺泡灌洗(BAL)治疗老年肺部感染的临床疗效。方法:将80例老年肺部感染患者随机分为治疗组40例和对照组40例。2组在全身应用抗生素、营养支持、纠正水电解质等治疗基础上,对照组给予常规吸痰治疗及体位引流排痰,治疗组每周行BAL治疗1～2次,比较2组临床表现和影像学变化以评价肺部感染控制情况。结果:治疗后动脉血氧分压、氧合指数治疗组均较对照组明显增高(P<0.01);治疗组缓解率(94.7%)(治愈率+好转率)明显高于对照组缓解率(77.5%)(P<0.05),治疗组抗生素疗程、病灶吸收天数和恢复白细胞计数正常时间均明显低于对照组(P<0.01)。结论:BAL对老年肺部感染是一种经济、安全、有效的治疗方法。

Objective：To observe the effect of bronchoalveolar lavage（BAL） on the pneumonia in the elderly. Methods：Eighty elderly patients with pneumonia were divided into BAL group（40 cases） and control group（40 cases）.In addition to the routine therapy of antibotics,nutritional support and acid-base balance,the BAL group was adopted to bronchoalveolar lavage（twice a week）,and the control group was subjected to sputum aspiration and postural drainage.The clinical presentation and the changes of laboratory and radiological results were compared between the two groups. Results：The PaO2 and the oxygenation index in the BAL group were significantly greater than that in the control group（P〈0.01）.The percentage of improvement rate in the BAL group（94.7%） was also significantly greater than that（77.5%） in the control group（P〈0.05）,iduration of lesions absorption,the course of antibiotic usage and resuming leukocyte natural times in the BAL group was significantly lower than that in the control group（P〈0.01）. Conclusions：The BAL may be an effective method for treatment of pneumonia in the elderly.