支气管镜肺泡灌洗与抗真菌药物治疗肺部真菌感染临床分析

Clinical effects of fiberoptic bronchoscope lavage and antifungal drugs on treatment of pulmonary fungal infections

目的探讨纤维支气管镜(FB)灌洗与抗真菌药物治疗肺部真菌感染(PFI)的效果。方法 2011年1月-2012年7月收治的168例PFI患者分成灌洗组和对照组,灌洗组84例患者,接受FB灌洗治疗;对照组84例患者,接受常规抗真菌治疗,比较两组患者治疗效果,使用SPSS 17.0软件进行统计分析。结果患者治疗显效率、总有效率灌洗组为64.3%、90.5%,均高于对照组的38.1%、66.7%(P<0.05);灌洗组总体疗效优于对照组,差异有统计学意义(P<0.01);两组患者治疗后PaO2、PaCO2比较,差异有统计学意义(P<0.01);灌洗组患者治疗后痰液真菌阴转率83.3%,高于对照组的61.9%(P<0.05);灌洗组发热天数、住院时间均低于对照组;对照组病死率14.3%,高于灌洗组的2.4%(χ2=3.8961,P=0.0484)。结论 FB灌洗抗真菌药治疗PFI,可以提高有效率、缩短病程、减少并发症,综合效价比较高。

OBJECTIVE To explore the effects of fiberoptic bronchoscope （FB） lavage and antifungal drugs on treat‐ment of pulmonary fungal infections .METHODS A total of 168 patients with pulmonary fungal infections who were treated in the hospital from Jan 2011 to Jul 2012 were divided into the lavage group and the control group ;84 cases in the lavage group received the FB lavage ,while 84 cases in the control group received the conventional antifungal drug therapy ;the curative effect was compared between the two groups ,and the statistical analysis was performed by using SPSS 17 .0 software .RESULTS The effective rate of treatment of the lavage group was 64 .3% ,higher than 38 .1% of the control group ;the total effective rate of the lavage group was 90 .5% ,higher than 66 .7% of the control group （P〈0 .05）;the overall curative effect of the lavage group was better than that of the control group ,there was significant difference （P〈0 .01） .As compared with the PaO2 and PaCO2 after the treatment , there was significant difference （P〈0 .01） .After the treatment ,the negative rate of sputum fungi of the lavage group was 83 .3% ,higher than 61 .9% of the control group （P〈0 .05）;the time of fever and length of hospital stay of the lavage group were shorter than those of the control group ;the mortality rate of the control group was 14 .3% ,higher than 2 .4% of the lavage group （χ2 =3 .8961 ,P=0 .0484） .CONCLUSION For the treatment of the pulmonary fungal infections ,the FB lavage and antifungal drug therapy can raise the effective rate ,shorten the course of illness ,and reduce the incidence of complication ,with the comprehensive efficacy high .