抗菌药物联合肺泡灌洗术对重症脑卒中合并肺部感染的疗效及对细菌清除率的影响

Effect of antibiotics combined with alveolar lavage on pulmonary infection and bacterial clearance in patients with severe stroke

目的 研究探讨抗菌药物联合肺泡灌洗术对重症脑卒中合并肺部感染的疗效及对细菌清除率的影响。方法 选取2019年1月—2021年1月某院收治的520例重症脑卒中合并肺部感染患者,随机数字表法分为观察组、对照组,每组260例。对照组给予常规抗感染治疗,观察组给予抗菌药物联合肺泡灌洗术治疗。评估比较两组患者的临床疗效、细菌清除率、症状消退时间、住院时间、炎症因子水平、不良反应发生率等指标。结果 观察组临床总有效率高于对照组,差异有统计学意义(χ^(2)=13.606,P<0.01)。相比对照组,观察组各项症状消退时间更快、住院时间更短。相比对照组,观察组超敏C-反应蛋白(high sensitivity C-reactive protein, hs-CRP)、白介素-1(Interleukin-1,IL-1)、降钙素原(procalcitonin, PCT)降低幅度更为明显。观察组细菌清除率高于对照组,差异有统计学意义(χ^(2)=10.417,P<0.01)。两组治疗期间不良反应发生率均较低,且差异无统计学意义(χ^(2)=0.894,P>0.05)。结论 抗菌药物联合肺泡灌洗术对重症脑卒中合并肺部感染患者的治疗效果显著,可促进患者症状消退,降低机体炎症因子水平,提高细菌清除率,安全性较好,可临床推荐。

Objective To investigate the efficacy of antibacterial drugs combined with alveolar on pulmonary infections in severe stroke and the effect on bacterial clearance.Methods A total of 520 cases with severe stroke combined with pulmonary infection admitted to a hospital from January 2019 to January 2021 were divided into observation and control groups by the random number table method, 260 cases in each group.The control group was given conventional anti-infection treatment, and the observation group was given antibacterial drugs combined with alveolar lavage.The clinical efficacy, bacterial clearance rate, time to resolution of symptoms, length of hospital stay, inflammatory factor levels and incidence of adverse reactions in the two groups were evaluated and compared.Results The total clinical efficiency of the observation group was higher than that of the control group, and the difference was ststistically significant(χ^(2)=13.606,P<0.01).Compared to the control group, the observation group showed faster resolution of all sysptoms and shorter hospital stay, the observation group showed a more significant reduction in high sensitivity C-reactive protein(hs-CRP),Interleukin-1(IL-1) and procalcitonin(PCT).The bacterial clearance rate in observation group was higher than that in the control group, and the difference was statistically significant(χ^(2)=10.417,P<0.01).The incidence of adverse reactions during treatment was lower in both groups and the difference was not statistically significant(χ^(2)=0.894,P>0.05).Conclusion Antibacterial drugs combined with alveolar lavage are effective in the treatment of patients with severe stroke complicated with pulmonary infection effect, which can promote the symptoms to subside, reduce the level of inflammatory factors, improve the bacterial clearance rate, and has good safety, which can be recommended in clinical practice.