经纤维支气管镜肺泡灌洗治疗重症肺炎的临床分析

Clinical Analysis of Bronchoalveolar Lavage in theTreatment of Severe Pneumo nia

目的：评价纤维支气管镜肺泡灌洗在重症肺炎治疗中的临床疗效与安全性。方法：回顾性分析2012年3月～2013年9月收治的86例重症肺炎患者的临床资料，根据治疗方法的不同分为观察组（42例）和对照组（44例），对2组患者的疗效及不良反应进行比较。结果：2组总有效率间差异的统计学意义具有显著性（x2＝23．62，P＜0．01），治疗组显效率、有效率及无效率（33．3％、57．1％、7．1％、90．5％）与对照组（18．2％、31．8％、27．2％）相比，组间差异均具有统计学意义（P＜0．05）。对照组除出现5例药物性皮疹外，无严重并发症；治疗组中有12例在治疗中出现心悸、气促等症状，给予暂停操作并吸氧后继续完成治疗。另有2例术后出现少量咯血，严密观察后自行缓解。治疗组所有患者术中、术后均未出现窒息、大咯血及心律失常等严重并发症。结论：经纤维支气管镜肺泡灌洗的治疗效果确实可靠，不良反应少，安全性高，能够更加有效的控制感染，是临床中治疗重症肺炎的可靠选择。

Objective：To evaluate bronchoalveolar lavage in the treatment of severe pneumonia the clinical curative effect and safety . Methods：A retrospective analysis of the clinical data of 86 cases from March 2012 to 2013 September were analyzed in patients with se-vere pneumonia , according to the different treatment methods for the observation group （ 42 cases ） and control group （ 44 cases ） , com-pared the efficacy and adverse reactions of two groups of patients .Results：Statistically significant difference between the two groups in to-tal effective rate between was significant （ =23.62,P＜0.01）, the efficiency of the treatment group, efficient and inefficient （33.3%, 57.1%, 7.1%, 90.5%） and control group （18.2%, 31.8%, 27.2%） compared to the differences between groups were statistically significant （P＜0.05 ）.The control group except 5 cases showed drug rash, no serious complication; treatment group 12 patients had heart palpitations , shortness of breath and other symptoms in treatment , to suspend operation and oxygen continue after completion of treat-ment.A small amount of hemoptysis and in 2 patients after operation , close observation of relieved .All the patients in the treatment group during and after the operation , there were no severe complications of massive hemoptysis asphyxia , and arrhythmia .Conclusion： The bronchoalveolar lavage treatment effect is reliable , less adverse reaction and high safety , can be more effective to control infection , is a re-liable choice in the clinical treatment of severe pneumonia .