纤维支气管镜灌洗治疗脑出血术后并发肺部感染临床研究

Clinical Study of Bronchofiberscope Lavage in the Treatment of Postoperative Pulmonary Infection after Intracerebral Hemorrhage

目的探讨纤维支气管镜灌洗治疗脑出血术后并发肺部感染临床效果。方法将我院2019年1月至2019年10月脑出血术后并发肺部感染患者100例,随机分组,常规治疗组患者采取常规祛痰抗感染等疗法治疗,纤维支气管镜灌洗组对本次患者采取常规祛痰抗感染等疗法+纤维支气管镜灌洗疗法治疗。比较两组脑出血术后并发肺部感染疗效;统计血象恢复至正常状态的时间、体温正常时间、X线胸片显示病灶吸收时间、痰菌转阴时间;分析治疗前后患者肺部炎症生化指标C反应蛋白、肿瘤坏死因子-α以及肺功能状态水平。结果纤维支气管镜灌洗组脑出血术后并发肺部感染疗效高于常规治疗组(P<0.05)。纤维支气管镜灌洗组血象恢复至正常状态的时间、体温正常时间、X线胸片显示病灶吸收时间、痰菌转阴时间短于常规治疗组(P<0.05)。纤维支气管镜灌洗组肺功能状态水平高于常规治疗组(P<0.05)。纤维支气管镜灌洗组肺部炎症生化指标C反应蛋白、肿瘤坏死因子-α低于常规治疗组(P<0.05)。结论常规祛痰抗感染等疗法+纤维支气管镜灌洗疗法治疗脑出血术后并发肺部感染效果良好,可有效改善患者的肺功能,控制肺部炎症,并加速患者病情的恢复,缩短治疗的时间。

Objective To explore the clinical effect of bronchofiberscope lavage in the treatment of postoperative pulmonary infection after intracerebral hemorrhage.Methods 100 patients with pulmonary infection after intracerebral hemorrhage operation in our hospital from January 2019 to October 2019 were randomly divided into two groups.The patients in the routine treatment group were treated with routine expectorant and anti infection therapy,while the patients in the fiberbronchoscope irrigation group were treated with routine expectorant and anti infection therapy plus fiberoptic bronchoscope irrigation therapy.The effect of pulmonary infection after intracerebral hemorrhage was compared between the two groups.The time of blood picture returning to normal state,normal temperature time,X-ray chest film showing the absorption time of focus and the time of sputum bacteria turning negative were counted.The levels of C-reactive protein,tumor necrosis factor-αand pulmonary function before and after treatment were analyzed.Results The curative effect of postoperative pulmonary infection in the bronchofibroscope group was higher than that in the routine treatment group(P<0.05).The time of recovery of hemogram to normal state,normal temperature,absorption time of focus on X-ray chest film and time of sputum bacteria turning negative in the fiberbronchoscope lavage group were shorter than those in the conventional treatment group(P<0.05).The level of pulmonary function in broncho fiberscope lavage group was higher than that in routine treatment group(P<0.05).The biochemical indexes of lung in ammation,such as C-reactive protein and tumor necrosis factor-αwere lower in the fiberbronchoscope lavage group than in the conventional treatment group(P<0.05).Conclusion Routine expectorant and anti infective therapy plus broncho fiberscope lavage can effectively improve the pulmonary function,control the pulmonary in ammation,accelerate the recovery of patients’condition and shorten the treatment time.