纤维支气管镜高频电刀治疗肺癌患者阻塞性肺炎临床分析

Clinical analysis on bronchoscopy high-frequent electro cautery in treatment of obstructive pneumonia patients with lung cancer

目的探讨抗感染序贯纤维支气管镜高频电刀介入治疗及化疗对肺癌合并阻塞性肺炎患者临床疗效,为临床诊治提供参考依据。方法选取2010年1月-2014年12月医院收治的80例肺癌并发阻塞性肺炎患者作为研究对象,收集患者痰液标本检测病原菌,并行药敏试验观察耐药性,及治疗前后临床指标比较,数据采用SPSS 18.0软件进行统计分析。结果 80例患者送检92份标本,共检出116株病原菌,以革兰阴性菌为主,共67株占56.78%;肺炎克雷伯菌、铜绿假单胞菌对美罗培南、亚胺培南敏感性较低,均<15.00%;第1秒呼出气体体积(FEV1)、最大肺活量(FVC)及卡氏评分(KPS)评分、气道腔径与治疗前比较均显著升高,治疗前后比较差异均有统计学意义(P<0.05)。结论肺癌合并阻塞性肺炎患者采用抗感染序贯纤维支气管镜高频电刀介入治疗、化疗临床疗效较好,可解除阻塞性肺炎临床症状,提高患者生存质量。

OBJECTIVE To explore the clinical efficacy of anti-infective sequential bronchoscopy high-frequent electro cautery in treatment of lung cancer combined with obstructive pneumonia,in order to provide reference for clinical diagnosis and treatment of lung cancer.METHODS A total of 80 patients with lung cancer combined with obstructive pneumonia from Jan.2010 to Dec.2014 in the hospital were selected.Sputum specimens were collected and pathogens were detected.The susceptibility testing was observed to analyze the resistance rate.Clinical indicators were compared before and after treatment.The data were analyzed by SPSS 18.0.RESULTS Totally 116 strains of pathogens were detected among 92 specimens of 80 patients,with the majority of 67 strains of gram-negative bacteria,accounting for 56.78%.Klebsiella pneumoniae,Pseudomonas aeruginosa was sensitive to meropenem and imipenem,with the drug resistance rates 〈15.00%.Compared with before treatment,the FEV1,FVC,KPS score and airway lumen diameter were significantly increased after treatment（P〈0.05）.CONCLUSION The clinical efficacy of anti-infective sequential bronchoscopy high-frequent electro cautery and chemotherapy in treatment of lung cancer combined with obstructive pneumonia is better,which can relieve obstructive pneumonia symptoms and improve the quality life of patients.