支气管镜联合头孢哌酮舒巴坦钠治疗大肠埃希菌相关性肺炎的效果及对呼吸功能的影响

Efficacy of bronchoscopy combined with cefoperazone-sulbactam sodium for treatment of Escherichia coli-associated pneumonia and its effect on respiratory function

目的探讨支气管镜联合头孢哌酮舒巴坦钠治疗大肠埃希菌相关性肺炎的效果及对呼吸功能的影响。方法将80例大肠埃希菌相关性肺炎患者随机分为药物治疗组和联合治疗组,各40例。药物治疗组患者使用头孢哌酮舒巴坦钠治疗,联合治疗组患者使用头孢哌酮舒巴坦钠联合支气管镜治疗。比较两组患者治疗前后炎症因子、T淋巴细胞亚群、呼吸力学指标水平,以及肺部感染、生活质量评分,对比两组患者临床症状消失时间和治疗效果。结果治疗后,联合治疗组患者血清白细胞介素(IL)-8、C反应蛋白、IL-6、CD8^+水平及呼吸做功、气道峰压、气道阻力、肺部感染评分均低于药物治疗组,CD3^+、CD4^+水平及动态顺应性、生活质量评分均高于药物治疗组(均P<0.05)。联合治疗组患者临床症状消失所需时间短于药物治疗组,治疗总有效率高于药物治疗组(均P<0.05)。结论支气管镜联合头孢哌酮舒巴坦钠治疗大肠埃希菌相关性肺炎能够减轻患者炎症反应,提高免疫能力,改善肺功能,缓解临床症状。

Objective To explore the efficacy of bronchoscopy combined with cefoperazone-sulbactam sodium for treating Escherichia coli-associated pneumonia and its effect on respiratory function. Methods Eighty patients with Escherichia coli-associated pneumonia were randomly divided into medication group and combined treatment group, with 40 cases in each group. Patients in the medication group were treated with cefoperazone-sulbactam sodium, and patients in the combined treatment group were treated with cefoperazone-sulbactam sodium combined with bronchoscopy. The levels of inflammatory factor, T lymphocyte subsets, respiratory mechanical indicators, as well as the scores for pulmonary infection and quality of life, were compared between the two groups before and after treatment, and duration for recovery from clinical symptoms and clinical efficacy were compared between the two groups as well.Results After treatment, the combined treatment group had lower serum levels of interleukin(IL)-8, C-reactive protein,IL-6 and CD8^+, lower work of breathing, peak inspiratory pressure, airway resistance and pulmonary infection score, and higher levels of CD3^+ and CD4^+, higher dynamic compliance and quality of life score as compared with the medication group(all P<0.05). The duration for recovery from clinical symptoms was shorter and the total effective rate for treatment was higher in the combined treatment group than in the medication group(all P<0.05). Conclusion Bronchoscopy combined with cefoperazone-sulbactam sodium can reduce inflammatory response, enhance immunity, improve pulmonary function and ameliorate clinical symptoms in the treatment of patients with Escherichia coli-associated pneumonia.