纤维支气管镜下肺泡灌洗治疗重型颅脑损伤并肺部感染的疗效分析

The treatment effect of fiber bronchoscopic lavage in patients with pulmonary infection after severe traumatic brain injury

目的探讨纤支镜下支气管肺泡灌洗治疗重型颅脑损伤并肺部感染的疗效。方法将72例重型颅脑损伤并肺部感染随机分为治疗组36例、对照组36例。对照组予以抗生素、营养支持、雾化吸入、经鼻导管吸痰等综合治疗,治疗组在综合治疗基础上经纤支镜下肺泡灌洗。对两组患者临床症状、体征、外周血白细胞计数、痰菌培养、有效率及治疗前后血气分析结果进行分析。结果治疗组体温恢复正常,痰液明显减少或消失,肺部啰音明显减少或消失,外周血白细胞计数正常,痰菌转阴时间均明显短于对照组(P<0.01),治疗组临床总有效率明显优于对照组(94.45%vs86.11%,P<0.05),纤支镜组治疗后血气改善明显(P<0.001)。结论纤支镜下支气管肺泡灌洗是一种安全有效的治疗重型颅脑损伤并肺部感染方法。

Objective To evaluate the bronchoalveolar lavage in the treatment of patients with pulmonary infection after severe traumatic brain injury. Methods Seventi-two patients with pulmonary infection after severe head injury were randomly divided into treat- ment group and the controls. All patients were treated with antibiotics, nutritional support, aerosol inhalation, nasal catheter suction of comprehensive treatment, and the patients in the treatment group were treatd by fiberoptic bronchoscopie lavage. The clinical symptoms, signs, white blood cell count, sputum culture, blood gas analysis result before and after the treatment were compared. Results The time of body temperature returned to normal, sputum decreased or disappeared, lung sounds decreased or disappeared, peripheral white blood cell count tunes to normal were significantly shorter than that of the control group （ P 〈 0. 01 ）. The clinical total effective rate of treatment group is significantly better than the that of control group （94. 45 % vs 86. 11%, P 〈 0. 05）. Conclusions Broncho,alveolar lavage is a safe and effective treatment for pulmonary infection patients after severe traumatic brain injury.