探讨纤支镜吸痰联合抗生素灌洗治疗重症肺部感染的疗效及对患者肺功能的影响

Explore the Curative Effect of Fiberoptic Bronchoscope Sputum Aspiration Combined with Antibiotic Lavage in the Treatment of Severe Pulmonary Infection and its Effect on Pulmonary Function of Patients

目的为了增强重症肺部感染治疗效果并尽可能促进患者肺功能的恢复,探讨采用纤支镜吸痰联合抗生素灌洗治疗的可行性。方法依据随机数字表法的相关要求从2017年3月—2018年3月由该院接诊的重症肺部感染患者中方便抽取120例作为研究对象并按照奇、偶数法将其平均分组(观察组和对照组各60例),仅给予抗感染、化痰以及机械通气等治疗措施的为对照组,在对照组治疗措施基础上同时采用纤支镜吸痰联合抗生素灌洗治疗的为观察组,比较两种治疗方案对疗效(退热时间、抗生素用药时间、辅助呼吸时间、呼衰纠正时间)、肺功能以及呼吸力学、炎症因子等指标的影响。结果该次研究显示,对照组患者治疗后退热时间、抗生素用药时间、辅助呼吸时间、呼衰纠正时间分别为(4.60±0.70)、(22.52±4.67)、(9.45±1.50)、(22.61±4.98)d,观察组患者治疗后退热时间、抗生素用药时间、辅助呼吸时间、呼衰纠正时间分别为(3.15±0.40)、(12.89±2.30)、(5.30±0.18)、(11.37±5.45)d,和对照组相比观察组各指标更占优势(t=5.645,5.337,5.179,6.615,P<0.05);对照组患者治疗后酸碱值(PH),二氧化碳分压(PCO2)以及氧分压(PO2)分别为(7.37±0.35)、(38.96±4.02)mmHg、(92.45±6.05)mmHg,观察组患者治疗后pH、PCO2、PO2分别为(7.19±0.05)、(45.37±6.77)mmHg、(81.03±8.96)mmHg,和对照组相比观察组血气指标改善更明显(t=5.941,6.335,6.101,P<0.05)。结论重症肺部感染患者在机械通气、抗感染等治疗措施基础上辅以纤支镜吸痰联合抗生素灌洗治疗,疗效可靠,在一定程度上改善了各临床指标,促进患者肺功能恢复,防止各种不良事件发生,值得推广。

Objective In order to enhance the therapeutic effect of severe pulmonary infection and promote the recovery of pulmonary function as far as possible,to explore the feasibility of bronchoscopic sputum aspiration combined with antibiotic lavage.Methods According to the relevant requirements of random number table method,120 patients with severe pulmonary infection were convenient selected from March 2017 to March 2018 and divided into two groups according to odd and even number method(60 cases in observation group and 60 cases in control group).Only anti-infection,expectoration and mechanical ventilation were given.The control group was treated with fiberoptic bronchoscope sputum aspiration combined with antibiotic lavage on the basis of the treatment measures of the control group as the observation group.The effects of the two treatment schemes on the curative effect(antipyretic time,antibiotic medication time,auxiliary breathing time,respiratory failure correction time),pulmonary function,respiratory mechanics and inflammatory factors were compared.Results The study showed that the time of fever abatement,antibiotic administration,assisted breathing and respiratory failure correction in the control group were(4.60±0.70)、(22.52±4.67)、(9.45±1.50)、(22.61±4.98)d,respectively.The time of fever abatement,antibiotic administration,assisted breathing and respiratory failure in the observation group were(3.15±0.40)d、(12.89±2.30)、(5.30±0.18)、(11.37±5.45)d,respectively.Compared with the control group,the indexes of the observation group were more predominant(t=5.645,5.337,5.179,6.615,P<0.05);In the control group,the pH value,carbon dioxide partial pressure(PCO2)and oxygen partial pressure(PO2)were(7.37±0.35),(38.96±4.02)mmHg,(92.45±6.05)mmHg,respectively.After treatment,PH,PCO2 and PO2 were(7.19±0.05),(45.37±6.77)mmHg,and(81.03±8.96)mmHg,respectively.Compared with the control group,the improvement of blood gas index was more obvious in the observation group(t=5.941,6.335,6.101,P<0.05).Conclusion On the basis of mechanical ventilation,anti-infection and other treatment measures,combined with fiberoptic bronchoscope sputum aspiration and antibiotic lavage,the curative effect of infected patients is reliable.To a certain extent,it improves the clinical indicators,promotes the recovery of pulmonary function,and prevents various adverse events.It is worth promoting.