纤维支气管镜吸痰联合生理盐水肺泡灌洗在鲍曼不动杆菌所致VAP患者中的疗效

Efficacy of branchofiberoscope sputum aspiration combined with saline alveolar lavage in patients with VAP caused by Acinetobacter baumannii

目的 探讨分析纤维支气管镜吸痰联合生理盐水肺泡灌洗在鲍曼不动杆菌所致呼吸机相关肺炎(VAP)患者中的疗效。方法 回顾性分析2018年1月至2021年4月浙江省嘉兴市第一医院收治的明确为鲍曼不动杆菌感染所致VAP患者54例,按照治疗方法的不同将患者分为对照组(n=27)和观察组(n=27)。对照组采用常规处理;观察组在常规处理的基础上加用纤维支气管镜吸痰联合生理盐水肺泡灌洗治疗,所有患者均治疗1周。对比观察两组患者的疗效、常规指标(ICU住院天数、机械通气时间、住院总费用等)、感染指标(降钙素原、中性粒细胞、白细胞总数)。结果 治疗后,对照组患者的治疗有效率低于观察组,差异有统计学意义(P<0.05);两组患者的降钙素原、中性粒细胞、白细胞总数均较治疗前降低,且观察组低于对照组(P<0.05);观察组的ICU住院天数、机械通气时间均短于对照组,住院总费用低于对照组,差异均有统计学意义(P<0.05)。结论 鲍曼不动杆菌所致VAP患者应用纤维支气管镜吸痰联合生理盐水肺泡灌洗疗效明显,患者满意度高,对临床推广发展具有现实意义。

Objective To investigate the efficacy of branchofiberoscope sputum aspiration combined with normal saline alveolar lavage in patients with VAP(ventilator-associated pneumonia)caused by Acinetobacter baumannii.Methods A total of 54 patients with VAP caused by Acinetobacter baumannii admitted to the First Hospital of Jiaxing in Zhejiang Province from January 2018 to April 2021 were selected for clinical study.All patients were divided into the control group(n=27)and the observation group(n=27)according to the random number table.The control group was treated with routine treatment.The observation group was treated with branchofiberoscope sputum suction combined with normal saline alveolar lavage based on routine treatment.All patients were treated for one week.The efficacy,routine indicators(number of days in the ICU,duration of mechanical ventilation,total hospital costs,etc.),and infection indicators(procalcitonin,neutrophils,total white blood cell count)were compared between the two groups.Results After treatment,the treatment efficiency of the control group was lower than that of the observation group,with a statistically significant difference(P<0.05).The procalcitonin,neutrophils,total white blood cell count of two groups after treatment were lower than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).The number of days in the ICU and mechanical ventilation time of observation group were shorter than those of the control group,and the total hospital costs of observation group was lower than that of the control group,with statistically significant differences(P<0.05).Conclusion Branchofiberoscope sputum aspiration combined with normal saline alveolar lavage is effective in treating VAP caused by Acinetobacter baumannii,with high patient satisfaction,which has practical significance for clinical promotion and development.