纤支镜下肺泡灌洗治疗难治性肺炎的临床应用分析

Clinical analysis of bronchoalveolar lavage under fiberbrochoscope in the treatment of refractory pneumonia

目的分析对难治性肺炎实施纤维支气管镜(纤支镜)下肺泡灌洗治疗的临床应用价值。方法 96例难治性肺炎患者作为研究对象,根据治疗方法的不同分为常规组与实验组,各48例。常规组实施常规治疗,实验组实施纤支镜下肺泡灌洗治疗。比较两组患者的临床治疗效果、治疗前后的血气分析指标以及临床体征消失时间。结果实验组总有效率95.83%高于常规组的77.08%,差异有统计学意义(P<0.05)。治疗后,两组患者的动脉血氧分压均较本组治疗前升高,动脉血二氧化碳分压均较本组治疗前降低,且实验组改善程度优于常规组,差异均具有统计学意义(P<0.05)。实验组咳痰消失时间、哮喘消失时间、哮鸣音消失时间分别为(5.01±0.66)、(2.92±0.19)、(4.11±0.99)d,均短于常规组的(7.88±1.04)、(6.06±1.25)、(6.99±1.46)d,差异均具有统计学意义(P<0.05)。结论对难治性肺炎实施纤支镜下肺泡灌洗治疗,不仅可以使患者的通气功能得到改善,还可以有效改善血气指标,让肺部病灶处保持在较高的药物浓度下,使其治疗效果更加明显,大大促进了临床体征的恢复,提高了治疗效果,值得在临床上推广应用。

Objective To analyze the clinical value of bronchoalveolar lavage under fiberbrochoscope in the treatment of refractory pneumonia. Methods A total of 96 refractory pneumonia patients as study subjects were divided into conventional group and experimental group by different treatment methods, with 48 cases in each group. The conventional group received conventional therapy, and the experimental group received bronchoalveolar lavage under fiberbrochoscope. The clinical effect, blood gas analysis indexes before and after treatment, and disappearance time of clinical signs was compared between the two groups. Results The total effective rate 95.83% in the experimental group was higher than 77.08% in conventional group, and the difference was statistically significant(P<0.05). After treatment, the arterial oxygen partial pressure in the two groups was higher than those before treatment, and arterial carbon dioxide partial pressure was lower than those before treatment. The improvement degree in the experimental group was better than that in the conventional group. Their difference was statistically significant(P<0.05). The disappearance time of cough, asthma and wheezing rale were(5.01±0.66),(2.92±0.19) and(4.11±0.99) d in the experimental group, which was shorter than(7.88±1.04),(6.06±1.25) and(6.99±1.46) d in the conventional group, and their difference was statistically significant(P<0.05). Conclusion For refractory pneumonia, bronchoalveolar lavage under fiberbrochoscope can not only improve the ventilation function of patients, but also effectively improve the blood gas index, keep the lung focus at a higher concentration of drugs, so that the treatment effect is more obvious, as well as greatly promoting the recovery of clinical symptoms and therapeutic effect. It is worthy of clinical promotion and application.