经纤维支气管镜阿米卡星肺泡灌洗对ICU重症肺炎患者的临床疗效分析

Clinical effect of amikacin bronchoalveolar lavage via fiberoptic bronchoscope on ICU patients with severe pneumonia

目的观察经纤维支气管镜阿米卡星肺泡灌洗对ICU重症肺炎患者的临床疗效。方法选取2018年8月至2019年8月本院ICU收治的70例重症肺炎患者作为研究对象,按照双色球随机分配法分为对照组(n=35)与实验组(n=35)。所有患者均给予常规祛痰、抗感染、吸氧等对症治疗,在此基础上两组患者均行经纤维支气管镜肺泡灌洗治疗,其中对照组患者灌洗液应用0.9%氯化钠溶液,实验组应用阿米卡星注射液,比较两组患者预后情况。结果治疗7 d后,实验组血气分析参数[动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、氧合指数(OI)]及气道炎症因子参数[白介素-6(IL-6)、肿瘤因子-α(TNF-α)、C反应蛋白(CRP)]等均优于对照组,差异有统计学意义(P<0.05)。治疗10 d后,实验组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论 ICU重症肺炎患者经纤维支气管镜阿米卡星肺泡灌洗治疗效果明显优于经纤维支气管镜0.9%氯化钠溶液肺泡灌洗,值得临床推广运用。

Objective To observe the clinical effect of amikacin bronchoalveolar lavage through fiberoptic bronchoscope on ICU patients with severe pneumonia.Methods 70 patients with severe pneumonia in ICU of our hospital fromAugust 2018 to August 2019 were selected as the research subjects.They were randomly divided into control group(n=35)and experimental group(n=35)according to the two-color ball random allocation method.All patients were given conventional expectorant,anti infection,oxygen inhalation and other symptomatic treatment.On this basis,the two groups of patients were treated with bronchoalveolar lavage through fiberoptic bronchoscope,and the control group was given lavage 0.9%sodium chloride solution,and amikacin injection was used in the experimental group.Results 3 days after treatment,the parameters of blood gas analysis(PaO2,PaCO2,OI)and airway inflammatory factors(IL-6,TNF-α,CRP)in the experimental group were better than those in the control group,the difference was statistically significant(P<0.05).10 days after reatment,the total effective rate of the experimental group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion The treatment effect of amikacin bronchoalveolar lavage through fiberoptic bronchoscope is better than that of 0.9%sodium chloride solution through fiberoptic bronchoscope in ICU patients with severe pneumonia,which is worthy of clinical application.