反复支气管冲洗治疗鲍曼不动杆菌感染的呼吸机相关性肺炎疗效分析

Analysis on the efficacy of repeated bronchial drainage treatment on patients with acinetobacter baumannii-caused ventilator-associated pneumonia

目的分析47例鲍曼不动杆菌感染的呼吸机相关性肺炎使用不同次数支气管冲洗引流治疗后的疗效及预后。方法选取确诊的多重耐药及泛耐菌株鲍曼不动杆菌感染的呼吸机相关性肺炎47例,所有患者分为两组,观察组予以3次/周以上的治疗,对照组予以1~2次/周支气管冲洗引流治疗,监测患者血氧饱和度、心率、血压、血白细胞及细菌培养的变化,同时对患者治疗好转率、细菌清除率、死亡率进行追踪及分析。结果两组患者治疗好转率差异无显著性（P〉0.05）,细菌清除率差异有显著性（P〈0.05）;治疗过程中有血压升高、心率加快、氧饱和度的降低等不良反应,但均无严重不良事件。结论 3次/周以上的支气管冲洗引流较多对鲍曼不动杆菌感染的呼吸机相关性肺炎细菌清除的疗效好,对患者病情好转及预后影响不大,1~2次/周,差异无显著性。

【Objective】To perform retrospective analysis on the therapeutic efficacy and prognosis of 47 cases of acinetobacter baumannii-causing ventilator-associated pneumonia treated with different times of bronchial drainage.【Method】47 patients diagnosed with ventilator-associated pneumonia caused by multi-resistant and pan-resistant strains of acinetobacter baumannii were selected.All patients were divided into two groups.The observation group was given bronchial drainage treatment for more than 3 times per week,and the control group was given the same treatment for 1 or 2 times per week.The variations of oxygen saturation,heart rate,blood pressure,blood leukocyte level and bacterial culture of the patients were monitored during the treatment procedure,and indexes include the improvement rate,the bacterial clearance rate and mortality were tracked and analyzed.【Result】Between two groups,significant difference was not observed in terms of improvement rate（P 0.05）,but was found in terms of bacterial clearance rate（P 0.05）;During the treatment,no serious adverse events occurred,while patients did experience adverse reactions including blood pressure decrease,heart rate increase and oxygen saturation decrease.【Conclusion】Compared with the control group,the observation group（treated with over 3 times of bronchial drainage per week） received better therapeutic efficacy in terms of bacteria clearance of acinetobacter baumanniicausing ventilator-associated pneumonia,while no significant difference was found in terms of the improvement rate and prognosis（P 0.05）,indicating that the treatment is generally safe.