纤维支气管镜肺泡灌洗治疗重症肺炎疗效观察

Observation of the curative effect of bronchoalveolar lavage in the treatment of severe pneumonia

目的观察纤维支气管镜肺泡灌洗对重症肺炎患者的治疗效果。方法将46例重症肺炎患者随机分为对照组和灌洗组,每组23例,对照组给予常规内科综合治疗,灌洗组在常规内科综合治疗中进行纤维支气管镜肺泡灌洗。观察灌洗组患者术前及术后6 h呼吸频率、心率、血气分析变化;比较2组患者咳嗽持续时间、肺部啰音消失时间、住院时间以及治疗后1周的血清降钙素原(PCT)、C-反应蛋白(CR);比较2组患者治疗2周后的临床疗效。结果纤维支气管镜肺泡灌洗术后6 h呼吸频率、心率、血气Pa O2及Pa CO2较术前明显改善,差异有统计学意义(P<0.05)。纤维支气管镜肺泡灌洗治疗1周后复查PCT、CRP,明显低于对照组,差异具有统计学意义(P<0.05)。经纤维支气管镜灌洗患者咳嗽持续时间、肺部啰音消失时间短于对照组,差异有统计学意义(P<0.05)。灌洗组住院时间明显少于对照组,差异显著(P<0.01)。灌洗组总有效率91.3%,对照组总有效率65.2%,2组比较具有统计学差异(P<0.05)。结论纤维支气管镜肺泡灌洗治疗重症肺炎疗效满意,安全性高,不良反应发生率低,临床上应推广使用。

Objective To observe fiber bronchoscope alveolar lavage for the treatment of patients with severe pneumonia. Methods 46 patients with severe pneumonia were randomly divided into control group and lavage group,23 cases in each group. The control group were received medicine treatment,Lavage group were received medicine treatment and fiber bronchoscope alveolar lavage. Observe the patients in lavage group of breathing rate,heart rate,blood gas analysis before lavage and 6 hours after lavage. Compare two groups of patients with cough,moist rales,hospital days,CRP and PCT levels after treatment for 1 week. Compare two groups of patients with clinical efficacy after 2 weeks of treatment. Results The breathing rate,heart rate,Pa O2 and Pa CO2 improved 6 h after,Fiberoptic bronchoscopy alveolar lavage（P〈0.05）.The PCT and CRP after 1week treatment,the lavage group had a better result than The control group（P〈0.05）.Duration of the cough time and rales disappear time in the lavage group was lower than the control group（P〈0.05）.The hospital days is shorter in lavage group（P〈0.05）.Lavage group total effectiveness 91.3%,control group total effective rate 65.2%,the result was statistically difference（P〈0.05）.Conclusion Fiberoptic bronchoscopy alveolar lavage in the treatment of severe pneumonia,has satisfied treatment effect with high safety,low incidence of adverse reactions.