纤维支气管镜联合氨溴索肺泡灌洗治疗脑梗死患者重症肺部感染伴肺不张的临床效果分析

Clinical efficacy of bronchoscopy combined bronchoalveolar lavage treatment by ambroxol in severe pulmonary infection and atelectasis patients of cerebral infarction

目的探讨纤维支气管镜联合氨溴索肺泡灌洗治疗脑梗死患者重症肺部感染伴肺不张的临床效果,并观察其对炎性因子的影响,为提高该病的治疗效果提供参考依据。方法选取医院2012年1月-2015年12月110例重症肺部感染伴肺不张的脑梗死患者作为研究对象,将其根据随机数字表法分为研究组与对照组,各55例,对照组给予抗感染和营养支持等常规治疗,研究组在对照组常规治疗基础上给予纤维支气管镜+氨溴索肺泡灌洗联合治疗,观察两组患者的临床疗效及炎性因子的变化。结果治疗前两组患者在NIHSS评分、CRP、PCT、WBC方面比较,差异无统计学意义,治疗后两组患者NIHSS评分、CRP、PCT、WBC均较治疗前显著降低,研究组降低程度大于对照组,组间差异有统计学意义(P<0.05);研究组患者呼吸衰竭好转、肺不张恢复、通气及住院时间分别为(1.6±0.5)(8.4±1.5)(1.0±0.2)(11.9±2.2)d,明显的低于对照组的(4.1±1.0)(12.5±2.0)(2.2±0.3)(18.4±2.7)d,两组数据比较,差异有统计学意义(P<0.05)。结论临床中对于重症肺部感染伴肺不张的脑梗死患者应用纤维支气管镜与氨溴索肺泡灌洗治疗临床疗效明显,并改善炎性因子的影响,更值得在临床中推广应用。

OBJECTIVE To investigate clinical efficacy of bronchoscopy combined bronchoalveolar lavage treatment by ambroxol in severe pulmonary infections and atelectasis patients of cerebral infarction,and its effects on inflammatory factors,so as to provide the basis for improvement of clinical efficacy.METHODS A total of 110 cases of severe pulmonary infections and atelectasis patients of cerebral infarction in the hospital from Jan.2012 to Dec.2015 were collected,and randomly divided into study group and control group according to random number table,with each group of 55 cases.Control group received anti-infective and nutritional support and other conventional treatment,study group received bronchoscopy combined bronchoalveolar lavage treatment based on conventional treatment,and clinical efficacy and changes of inflammatory factors were observed in both groups.RESULTS There was no significant difference of NIHSS score,CRP,PCT,and WBC between two groups of patients before treatment.After treatment,NIHSS score,CRP,PCT,and WBC of two groups of patients were significantly lower than those before treatment,study group decreased more than control group,and the difference between two groups was significant（P〈0.05）.The respiratory failure better time,atelectasis recovery time,ventilation time and hospital stay of study group were（1.6±0.5）d,（8.4±1.5）d,（1.0±0.2）d,and（11.9±2.2）d,respectively,significantly lower than（4.1±1.0）d,（12.5±2.0）d,（2.2±0.3）d,and（18.4±2.7）d of control group,and the data between two groups had significant difference（P〈0.05）.CONCLUSION Bronchoscopy combined bronchoalveolar lavage treatment by ambroxol has obvious clinical curative effect,and can improve the impact of inflammatory factors,so it is more worthy of clinical application and promotion.