经纤维支气管镜肺泡灌洗治疗重症肺炎的临床研究

Clinical study of bronchoalveolar larage in treatment of severe pneumonia

目的：观察经纤维支气管镜肺泡灌洗治疗急性重症肺炎的临床价值。方法：31例重症肺炎患者在常规治疗基础上行支气管肺泡灌洗，并与同期26例常规治疗患者作比较，观察两组病例的治疗疗效，记录并分别比较两组在灌洗前及灌洗后48h的急性生理学和慢性健康状况Ⅱ（APACHEⅡ）评分、急性肺损伤评分和肺感染评分。结果：灌洗组患者在灌洗48h后与非灌洗组相比，各项评分均有显著下降，明显低于非灌洗组（P〈0．05）；灌洗组总有效率为93．5％，与非灌洗组总有效率76．9％相较有显著性差异（P〈0．05）。结论：经纤维支气管镜肺泡灌洗治疗急性重症肺炎，疗效确切，可缩短病程，提高治愈率。

Objective To explore the clinical value of bronchoalveolar larage （BAL） in the treatment of severe pneumonia. Methods 57 patients were randomly divided into BAL group and non-BAL group, 31 patients in the BAL group received BAL in addition of roution treatment and 26 patients had only roution treatment in the non-BAL group. The effect of the 2 groups was observed and APACHE 1I score, Acute Lung injury score, Pulmonary infection score were compared Comparisons between the 2 groups. Results compared to the non-BAL group, efficient in the BAL group was 93.5% but 76.9% in the non-BAL group. APACHE Ⅱ score, Acute Lung injury score, Pulmonary infection score in the BAL group were significantly lower than in the non-BAL group. Conclusion bronchoalveolar larage was effective in the treatment of severe pneumonia, and shortening the course and improving the cure rate.