纤维支气管镜肺泡灌洗治疗颅脑损伤后肺部感染的临床疗效观察

Therapeutic effects of fiber optic bronchoscope alveolar lavage in the treatment of lung infection after traumatic brain injury

目的探讨纤维支气管镜肺泡灌洗治疗颅脑损伤后肺部感染的临床治疗效果及安全性。方法将61例颅脑损伤气管切开合并肺部感染的病例随机分为治疗组和对照组,对照组(30例)给予常规静脉应用抗菌药物抗感染、祛痰、吸痰管吸痰等治疗,治疗组(31例)在常规治疗基础上采用纤维支气管镜肺泡灌洗治疗。比较治疗前后两组患者的体温、临床症状、体征、动脉血气分析及肺部影像学检查结果。结果经纤维支气管镜下吸痰及肺泡灌洗治疗后患者体温、血常规、肺部炎症等指标明显优于对照组;实验组患者的总有效率(93.6%)高于对照组(66.7%);两组治疗后血气分析结果均达到一定程度的好转,纤维支气管镜灌洗治疗后患者的pH、PaO2、PaCO2、SaO2等指标明显优于对照组,两组比较差异有统计学意义(P<0.05)。结论纤维支气管镜肺泡灌洗是治疗颅脑损伤后肺部感染的一种疗效明确、操作方便、安全可靠的方法,值得临床推广使用。

Objective To investigate the clinical efficacy and securities of fiber optic bronchoscope alveolar lavage in the treatment of lung infection after traumatic brain injury. Methods 61 patients with lung infection after traumatic brain injury were randomly divided into treatment group and control group. Control group（n = 30）was treated with anti-infection,eliminating sputum and sucking phlegm sputum suction pipe,treatment group（ n = 31） was treated with fiber optic bronchoscope alveolar lavage based on the routine treatment. The patients＇ body temperature,clinical symptoms,signs,arterial blood gas analysis and lung imaging examination of the two groups were compared. Results The clinical indicators（body temperature,blood routine indexes,pulmonary inflammation） of the patients in the treatment group were better than those of control group,there were significant differences between the two groups（P〈0.05）. The total effective rate of treatment group（93.6%）was significantly higher than that of control group（66.7%）. The clinical indicators（pH,PaO2,PaCO2,SaO2）of the two groups were improved to a certain extent,the results of treatment group after the treatment of fiber optic bronchoscope alveolar lavage were significantly better than those of control group,there were significant differences between the two groups（P〈0. 05）. Conclusion The method of fiber optic bronchoscope alveolar lavage is therapeutic,safe,reliable and easy to treat the lung infections after traumatic brain injury. It is worthy of promotion.