肺泡灌洗术对高血压脑出血患者肺部感染状态及感染相关指标的影响

Effect of alveolar lavage on infection status and infection-associated indexes in patients with hypertensive intracerebral hemorrhage

目的观察肺泡灌洗对于高血压脑出血合并肺部感染的影响,分析肺泡灌洗的治疗价值。方法选取2013年5月-2015年4月医院接受肺泡灌洗治疗的78例高血压脑出血合并肺部感染患者为灌洗组,选取78例未接受肺泡灌洗治疗的高血压脑出血合并肺部感染患者为对照组,对比分析治疗前后两组患者血清炎症标志物以及临床肺部感染评分的变化,同时对两组临床疗效进行评价和比较。结果治疗后,灌洗组血清CRP[(4.25±2.57)mg/L]、WBC[(13.62±3.09)×10~9/L]、PCT[(1.18±0.54)ng/ml]、CPIS评分[(0.74±0.21)分]明显低于对照组(P<0.05);但灌洗组临床有效率(83.33%)明显高于对照组(P<0.05)。结论肺泡灌洗能够通过抑制炎症反应、减轻感染程度等途径对高血压脑出血合并肺部感染预后产生促进作用,是高血压脑出血合并肺部感染高效的治疗手段之一。

OBJECTIVE To observe the effect of alveolar lavage on patients with hypertensive intracerebral hemor- rhage complicated with pulmonary infection and analyze the therapeutic value of alveolar lavage. METHODS A to- tal of 78 patients with hypertensive intracerebral hemorrhage complicated with pulmonary infection treated with alveolar lavage from May 2013 to Apr. 2015 in our hospital were selected as lavage group, and 78 hypertensive in- tracerebral hemorrhage patients with pulmonary infection without pulmonarY）embolism were set as control group. The changes of serum inflammatory markers and clinical pulmonary infection score were compared before and after treatment. After treatment, the clinical curative effect of the two groups was evaluated and compared. RESULTS After treatment, the serum CRP [（4.25±2.57）mg/L], WBS[（13. 62±3. 09） × 109/L], PCT[（1.18±0.54）ng/ ml], and CPIS score （0.74±0.21） of lavage group were significantly lower than those of control group （P〈0.05）, but the clinical effective rate （83.33%） of lavage group was significantly higher than that of control group （P〈0.05）. CONCLUSION Pulmonary lavage can promote the prognosis of hypertensive intracerebral hemorrhage and pulmonary infection by suppressing inflammatory reaction and reducing the infection degree. It is one of the effective treatment methods for hypertensive intracerebral hemorrhage complicated with pulmonary infection.