美罗培南联合纤维支气管镜灌洗治疗重症肺炎临床对照观察

Clinical controlled observation of meropenem combined with lavage via fiberoptic bronchoscopy in the treatment of severe pneumonia

目的探讨美罗培南联合纤维支气管镜灌洗治疗重症肺炎的临床疗效及对患者炎症反应、肺功能的影响。方法将106例重症肺炎患者按随机数字表法分为研究组、对照组,各53例。对照组给予美罗培南治疗,研究组给予美罗培南联合纤维支气管镜灌洗治疗,观察2周。比较两组疗效及治疗前后肺功能(呼气流量峰值、用力肺活量)、炎症因子(C反应蛋白、白细胞介素-6、血清降钙素原)水平及白细胞计数。结果研究组总有效率显著高于对照组(P<0.05)。治疗后研究组C反应蛋白、白细胞介素-6、血清降钙素原水平、白细胞计数及二氧化碳分压均显著低于对照组(P<0.05或0.01),呼气流量峰值、用力肺活量、第一秒用力呼吸容积率、血pH值、氧分压显著高于对照组(P<0.05或0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论美罗培南联合纤维支气管镜灌洗治疗重症肺炎疗效较好,可显著改善患者肺功能及炎症反应,安全性高。

Objective To explore the clinical efficacy of meropenem combined with lavage via fiberoptic bronchoscopy in the treatment of severe pneumonia and its influence on patients'inflammatory response and lung function.Methods A total of 106 patients with severe pneumonia were divided into a study group and a control group according to random number table method,with 53 cases in each group.The control group was treated with meropenem,and the study group was treated with meropenem combined with lavage via fiberoptic bronchoscopy foR2 weeks.The curative effect,lung function[peak expiratory flow(PEF),forced vital capacity(FVC)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),serum procalcitonin(PCT)]and white blood cell count(WBC)were compared between the two groups before and after treatment.Results The total effective rate of study group was significantly higher than that of control group(P<0.05).After treatment,CRP,IL-6,serum PCT,WBC and carbon dioxide partial pressure(PaCO_(2))in the study group were significantly lower than those in the control group(P<0.05 oR0.01),and PEF,FVC,forced expiratory volume in 1 second(FEV1),blood pH and oxygen partial pressure(PaO_(2))were significantly higher than those in the control group(P<0.05 oR0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Meropenem combined with lavage via fiberoptic bronchoscopy is effective in the treatment of severe pneumonia.It can significantly improve the lung function and inflammatory response of patients with safety.