纤维支气管镜治疗矽肺合并重症肺部感染的疗效

Efficacy of fiberoptic bronchoscopy on silicosis combined with severe lung infection

目的探讨经纤维支气管镜对矽肺患者肺部局部感染病灶(参照肺部CT影像定位)行支气管肺泡灌洗加全身抗感染治疗矽肺合并重症肺部感染患者的疗效。方法将广西壮族自治区职业病防治研究院2009—2011年收治的32例矽肺合并重症肺部感染患者随机分为2组,观察组(16例)给予纤维支气管镜行支气管肺泡灌洗及局部用药,每周期2次,并全身抗感染及支持对症治疗,根据药敏结果选用抗生素;对照组(16例)单用抗生素全身抗感染及对症支持治疗。结果观察组16例治疗后的血气分析指标均较治疗前改善(均P<0.01),其显效率为75.0%,总有效率为93.8%;对照组16例,显效率为37.5%,总有效率为75.0%,治疗组显效率明显高于对照组(χ2=4.571,P<0.05)。结论经支气管镜行支气管肺泡灌洗治疗,能及时清除气道分泌物,改善肺通气功能,可明显提高矽肺重症肺部感染患者的治愈率,是一种治疗重症肺部感染行之有效的治疗方法,值得临床进一步研究推广。

[Objective]To explore the efficacy of fiberoptic bronchoscopy on patients with silicosis combined with severe lung infection via bronchoalveolar lavage plus systemic anti-infective therapy on local infection lesions which were located by lung CT images.[Methods]A total of 32 cases of silicosis combined with severe lung infection inpatients in Guangxi Institute for Occupational Disease Prevention and Treatment from 2009-2011 were recruited and randomly divided into observation group and control group with 16 cases in each group.Bronchoalveolar lavage via fiberoptic bronchoscopy and drug administration on local lesions was performed twice a week on patients in observation group,as well as plus systemic anti-infective therapy according to susceptibility results.Antibiotics systemic anti-infective and symptomatic treatment was conducted in control group.[Results] Blood gas indicators of 16 patients in observation group were well improved after treatment（all P 0.01）,with obvious effective rate of 75.0% and total effective rate of 93.8%.Those of control group was 37.5% and 75.0%,significantly lower than observation group（χ2=4.571,P0.05）.[Conclusion]Bronchoalveolar lavage via fiberoptic bronchoscopy can timely remove airway secretions,improve lung function,can significantly improve cure rate of silicosis patients with severe pulmonary infection.It is an effective treatment method for severe pulmonary infection and worthy of further clinical research and promotion.