抗生素支气管肺泡灌洗治疗重症老年细菌性肺炎的疗效分析

Analysis of effect of antibiotic bronchoalveolar lavage on patients with severe bacterial pneumonia

目的探讨分析重症老年细菌性肺炎患者应用抗生素支气管肺泡灌洗等治疗对肺功能及炎症介质的影响。方法选取2015年1月~2016年11月怀化市第一人民医院收治的重症老年细菌性肺炎患者60例,根据随机数字表法分为观察组和对照组,每组各30例。对照组静脉给予抗生素等治疗,观察组在在对照组的基础上加用抗生素支气管肺泡灌洗治疗。比较两组患者治疗前后一秒钟用力呼气容积(FEV1)、最大呼气流量(PEFR)、最大自主通气量(MVV)等肺功能指标以及内毒素(LPS)、肿瘤坏死因子-2(TNF-2)和白细胞介素-6(IL-6)等炎症因子。结果治疗前,两组FEV_1、PEFR、MVV%比较,差异无统计学意义(P>0.05);治疗后,两组FEV1、PEFR、MVV%均较前明显改善,且观察组患明显优于对照组,差异有统计学意义(P<0.05)。治疗前,两组LPS、TNF-2、IL-6比较,差异无统计学意义(P>0.05);治疗后,两组LPS、TNF-2、IL-6均较治疗前明显改善,且观察组明显优于对照组,差异有统计学意义(P<0.05)。结论应用抗生素支气管肺泡灌洗等治疗在重症老年细菌性肺炎患者的临床治疗中,可以有效地改善患者的肺功能,有效地控制、缓解患者肺部炎症情况,在其应用治疗中具有较好的临床治疗效果,值得临床上进一步推广应用。

Objective To investigate and analyze of the effect of antibiotic bronchoalveolar lavage on pulmonary function and inflammatory mediators in patients with severe bacterial pneumonia. Methods From January 2015 to November 2016, in Huaihua First People＇s Hospital, 60 patients with severe bacterial pneumonia were selected, according to the random number table method, they were divided into observation group and control group, with 30 cases in each group. The control group ,sas treated with antibiotics by intravenous administration, and the observation group was treated with antibiotic by bronchoalveolar lavage on the basis of the control group. The lung function index of forced epiratory volume in one second （FE~ 1）, peak expiratory flow rate （PEFR） and max volume value （MVV）, the inflammatory factor of lipopolysaccharide （LPS）, tumor necrosis factor-2 （TNF-2） and interleukin-6 （IL-6） before and after treatment in two groups were compared. Results Before the treatment, the FE1, PEFR, MVV in two groups were compared, the differences were not statistically significant （P 〉 0.05）, after the treatment, the FEV1, PEFR, MVV in two groups were significantly better than before the treatment, the differences were statistically significant （P 〈 0.05）, and observation group were significantly better than the control group, the differences were statistically significant （P 〈 0.05）. Before the treatment, the LPS, TNF-2 and IL-6 in two groups were compared, the differences were not statistically significant （P 〉 0.05）, after the treatment, the LPS, TNF-2 and IL-6 in two groups were significantly better than before the treatment, the differences were statistically significant （P 〈 0.05）, and observation group were significantly better than the control group, the differences were statistically significant （P 〈 0.05）. Conclusion Application of antibiotic hronchoalveolar lavage in the treatment of elderly patients with severe bacterial pneumonia can effectively improve the patient＇s lung function, effectively control and alleviate the lung inflammation, the application of treatment have good clinical effect, and it＇s worthy of further clinical application.