鼻咽癌放疗后吸入性肺炎早期纤维支气管镜治疗效果观察

Therapeutic value of early bronchoscopy in aspiration pneumonia patients after nasopharyngeal carcinoma radiotherapy

回顾性分析2005年1月至2010年12月住院治疗的41例患者，均为鼻咽癌放疗后合并吸入性肺炎者，其中早期纤维支气管镜治疗组24例（A组），单纯常规治疗组17例（B组）。分析早期纤维支气管镜治疗对鼻咽癌放疗后吸入性肺炎患者体温、血象、影像学肺部吸收和死亡率的影响。治疗前A组与B组的体温和血WBC处于同一水平[（38．7±0．7）℃与（38．5±0．7）℃，P=0．633；（15．8±4．2）×109／L与（16．2±3．4）×109／L，P=0．430]，治疗3d后两组体温差异具有统计学意义[（37．3±0．9）℃与（38．4±1．4）℃，P=0．015]；治疗5d后两组白细胞差异有统计学意义[（10．6±4．2）×109／L与（15．3±6．9）×109／L，P=0．045]；A组肺部影像学改变较常规组吸收更快（z=-3．515，P=0．00），两组死亡率没有统计学差异。

A total of 41 patients with aspiration pneumonia after nasopharyngeal carcinoma radiotherapy were retrospectively selected from January 2005 to December 2010. They were divided into early bronehoscopy group （n = 24） and conventional therapy group （n = 17） to analyze the therapeutic effects of early bronehoscopy on temperature, white blood cell （WBC） , absorption of chest radiography and mortality rates. The temperature and WBC were at the same level between both groups at pre-treatment [ （38.7 ± 0.7）℃ vs. （38.5±0.7）℃, P=0.633; （15.8±4.2） ×l09/Lvs. （16.2 ±3.4） ×l09/L, P=0.430] while the temperature declined obviously after a 3-day treatment [ （37.3±0. 9） ℃ vs. （38.4 ± 1.4） ℃, P = 0. 015 ] and also WBC after a 5-day treatment[（10. 6±4.2） ×109/L vs. （15.3 ±6.9）× 109/L, P= 0. 045]. The bronehoscopy group had a faster absorption of chest radiography （Z = -3. 515, P =0. 00）. The mortality rate showed no statistically significant difference between both groups.