左氧氟沙星联合阿米卡星经气管镜下注药治疗支气管扩张的临床观察

Clinical observation of Levofloxacin combined with Amikacin by bronchoscopic administration in the treatment of bronchiectasis

目的观察经气管镜下注入左氧氟沙星联合阿米卡星对支气管扩张的临床疗效。方法选取2017年6月~2019年6月本院呼吸内科收治的支气管扩张患者90例,按随机化原则分为观察组45例和对照组45例,所有患者均予经气管镜下肺泡灌冼,观察组在经气管镜下肺泡灌冼后经气管镜注入左氧氟沙星及阿米卡星,每3天注药1次,疗程1周,治疗后比较两组患者总有效率、血气分析氧分压(PaO2)、动脉血氧饱和度(SaO2)、氧合指数(PaO2/FiO2)的变化、炎症因子白细胞(WBC)、高敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、肿瘤坏死因子(TNF-α)的变化。结果观察组患者总有效率高于对照组,血气分析PaO2、SaO2、PaO2/FiO2高于治疗前、对照组,炎症指标WBC、hs-CRP、PCT、TNF-α低于治疗前、对照组,差异有统计学意义(P<0.05)。结论经气管镜下注入左氧氟沙星联合阿米卡星治疗支气管扩张疗效明显,推荐临床应用。

Objective To observe the clinical efficacy of Levofloxacin combined with Amikacin by bronchoscopic administration in the treatment of bronchiectasis.Methods Ninety patients with bronchiectasis received by our Department of Respiratory Medicine from June 2017 to June 2019 were selected and divided into observation group(45 cases)and control group(45 cases)as randomization principle.All patients received bronchoalveolar lavage under bronchoscope.The observation group was administered with levofloxacin and amikacin under bronchoscope after the above lavage,once every three days,lasting one week as a cycle.Changes of the overall response rates,arterial blood gas analysis(PaO2),arterial oxygen saturation(SaO2)and oxygenation index(PaO2/FiO2)and changes of inflammatory factor white blood cell(WBC),high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)and tumor necrosis factor(TNF-α)after treatment were compared between two groups.Results The overall response rate for patients of observation group was higher than that of control group,blood gas analysis PaO2,SaO2 and PaO2/FiO2 were higher than those before treatment and those of control group.While the inflammatory indexes,like WBC,hs-CRP,PCT and TNF-αwere lower than those before treatment and those of control group,with statistically significant difference(P<0.05).Conclusion The efficacy of Levofloxacin combined with Amikacin by bronchoscopic administration was significant and recommended for clinical application.