经纤维支气管镜肺泡灌洗用于急性肺脓肿的疗效研究

Alveolar Lavage by Fiberoptic Bronchoscopy for Efficacy Studies of Acute Pulmonary Abscess

目的:观察经纤维支气管镜肺泡灌洗(bronchoal-ceolar lavage.BAL)在用于治疗急性肺脓肿方面的临床疗效。方法:将60例急性肺脓肿患者随机分为两组,对照组28例,治疗组32例,对对照组患者采用单纯的常规内科治疗,即包括敏感抗生素治疗并配合体位引流、祛痰、雾化和全身营养支持等综合治疗,而对治疗组患者采用的是常规内科治疗联合利用自行配置的灌洗液进行BAL治疗。结果:对照组治愈13例,好转5例,无效9例,死亡1例,治愈率为46.4%,总有效率为64.3%。治疗组治愈23例,好转6例,无效3例,治愈率为71.9%,总有效率为90.6%;两组治愈率及总有效率比较,差异显著,具有统计学意义(P<0.05)。对照组体温恢复正常时间为(18.1±4.3)d,治疗时间为(35.2±6.9)d,与治疗组患者体温恢复正常时间为(11.3±3.4)d,治疗时间为(23.2±5.1)d。两组体温恢复时间和治疗疗程相比较差异显著,具有统计学意义(P<0.05)。结论:经纤维支气管镜肺泡灌洗结合局部用药治疗,能达到促进体位引流、增加抗生素在感染部位浓度的目的,从而提高疗效,大大缩短疗程,值得临床上大力推广。

Objective Observed by fiberoptic bronchoscopy alveolar lavage( bronchoal-ceolar lavage. BAL) clinical efficacy for the treatment of acute pulmonary abscess. Method 60 patients with acute lung abscess patients were randomly divided into two groups,the control group,28 cases,32 cases of the treatment group and a control group of patients with purely conventional medical treatment,that was,including the sensitive antibiotic treatment with postural drainage,expectorant,atomization and systemic nutrition support therapy,treated patients with conventional medical therapy combined with self-configuration of lavage fluid bal treatment. Results Control group,13 cases were cured,5 cases improved,9 cases failed,1 case died,the cure rate was 46. 4%,the total effective rate was 64. 3%. Treatment group,23 cases were cured,improved in 6 cases,3 cases failed,the cure rate was 71. 9%,the total effective rate was 90. 6%; two groups of cure rate and the total effective rate were compared,the difference was statistically significant( P < 0. 05). Control group,the body temperature returned to normal time was( 18. 1 ± 4. 3) days,treatment time was( 35. 2 ± 6. 9) days,treatment group patients body temperature returned to normal time was( 11. 3 ± 3. 4) days,treatment time was( 23. 2 ± 5. 1) days. The two sets of temperature recovery time and treatment time were compared the difference was statistically significant( P < 0. 05). Conclusion Lavage combined with topical treatment by fiberoptic bronchoscopy can reach to promote postural drainage,increase antibiotic concentration at the site of infection purposes,thereby enhancing the efficacy,greatly shorten the course of treatment. It is worth of clinical vigorously application.