纤维支气管镜局部灌洗术联合甲硝唑和莫西沙星治疗肺脓肿患者的效果

Effects of fiberoptic bronchoscopy local lavage combined with Metronidazole and Moxifloxacin in treatment of patients with lung abscess

目的:观察纤维支气管镜局部灌洗术联合甲硝唑和莫西沙星治疗肺脓肿患者的效果。方法:选取 2019 年 1 月至 2021 年1 月该院收治的 86 例肺脓肿患者进行前瞻性研究,按照随机数字表法分为对照组和研究组各 43 例。两组均接受机械通气、常规雾化和吸痰治疗等,在此基础上,对照组给予甲硝唑联合莫西沙星治疗,研究组在对照组基础上联合纤维支气管镜局部灌洗治疗。比较两组临床症状缓解时间、临床疗效、治疗前后血气分析指标 [pH 值、氧分压(PO)、二氧化碳分压(PCO)] 水平,以及不良反应 / 并发症发生率。 结果:研究组呼吸困难缓解时间、体温恢复正常时间和咳嗽缓解时间均短于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为 90.70%,高于对照组的 72.09%,差异有统计学意义(P<0.05);治疗后,两组 pH 值和 PO水平均高于治疗前,且研究组高于对照组,两组 PCO水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应 / 并发症发生率比较,差异无统计学意义(P>0.05)。结论:纤维支气管镜局部灌洗联合甲硝唑和莫西沙星治疗肺脓肿患者可提高治疗总有效率,缩短临床症状缓解时间,以及改善血气分析指标水平,效果优于单纯甲硝唑联合莫西沙星治疗。

Objective: To observe effects of fiberoptic bronchoscopy local lavage combined with Metronidazole and Moxifloxacin in treatment of patients with lung abscess. Methods: 86 patients with lung abscess admitted to our hospital from January 2019 to January 2021were selected for the prospective study, and were divided into control group and study group according to the random number table method,43 cases in each group. Both groups received mechanical ventilation, conventional nebulization and sputum suction. On this basis, the control group was treated with Metronidazole combined with Moxifloxacin, while the study group was treated with fiberoptic bronchoscopy local lavage on the basis of that of the control group. The clinical symptom relief time, the clinical efficacy, the blood gas analysis index levels[pH value, partial pressure of oxygen (PO), partial pressure of carbon dioxide (PCO)] before and after the treatment, and the incidence of adverse reactions/complications were compared between the two groups. Results: The respiratory failure correction time, the time for body temperature to return to normal, and the cough relief time in the study group were shorter than those in the control group, and the differences were statistically significant (P<0.05). The total effective rate of treatment in the study group was 90.70%, which was higher than the control group of 72.09%, and the difference was statistically significant (P<0.05). After the treatment, the pH and POlevels of the two groups were higher than those before the treatment, and those of the study group were higher than those of the control group;the PCOlevels of the two groups were lower than before the treatment, and that of the study group was lower than that of the control group;and the differences were statistically significant (P<0.05). However, there was no significant difference in the incidence of adverse reactions/complications between the two groups (P>0.05). Conclusions: Fiberoptic bronchoscopy local lavage combined with Metronidazole and Moxifloxacin in the treatment of patients with lung abscess can improve the total effective rate of treatment, shorten the clinical symptom relief time, and improve the levels of blood gas analysis indexes. Moreover, it is superior to single Metronidazole combined with Moxifloxacin treatment.