支气管镜肺泡灌洗联合阿米卡星局部给药对支气管扩张合并感染患者炎症因子及临床症状的影响

Effects of Bronchoscopy Alveolar Lavage Combined with Local Administration of Amikacin on Inflammatory Factors and Clinical Symptoms in Patients with Bronchiectasis and Infection

目的:分析支气管镜肺泡灌洗联合阿米卡星局部给药在支气管扩张合并感染患者中的治疗效果。方法:选取2021年7月—2023年1月丰城矿务局总医院收治的80例支气管扩张合并感染患者,按随机数字表法分为两组,各40例。对照组给予常规治疗+支气管镜肺泡灌洗治疗,观察组加用阿米卡星局部给药治疗,连续治疗2周。对比两组临床疗效、症状改善情况、炎症因子水平、肺功能。结果:观察组治疗总有效率为95.00%(38/40),高于对照组的80.00%(32/40)(P<0.05)。观察组咳嗽消失时间为(4.26±0.89)d、发热消失时间为(3.19±0.63)d、肺部湿啰音消失时间为(7.21±1.34)d,均短于对照组的(6.31±1.59)、(5.48±1.20)、(9.75±1.88)d,差异均有统计学意义(P<0.05)。治疗前,两组降钙素原(PCT)、C反应蛋白(CRP)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)、用力肺活量(FVC)相比,差异均无统计学意义(P>0.05);治疗后,观察组PCT为(0.84±0.15)ng/m L、CRP为(6.20±1.28)mg/L,均低于对照组的(1.38±0.26)ng/mL、(8.31±1.57)mg/L;观察组FEV1为(2.25±0.58)L、PEF为(3.48±0.69)L/s、FVC为(3.41±0.71)L,均高于对照组的(1.78±0.43)L、(2.69±0.58)L/s、(2.96±0.60)L,差异均有统计学意义(P<0.05)。结论:支气管镜肺泡灌洗+阿米卡星局部给药能够加快支气管扩张合并感染患者症状消退,降低炎症因子水平,改善肺功能。

Objective:To analyze the therapeutic effect of bronchoscopy alveolar lavage combined with local administration of Amikacin in patients with bronchiectasis and infection.Method:A total of 80 patients with bronchiectasis and infection admitted to Fengcheng Mining Bureau General Hospital from July 2021 to January 2023 were selected,and divided into two groups by random number table method,with 40 cases in each group.The control group was treated with routine treatment+bronchoscopy alveolar lavage,and the observation group was treated with local administration of Amikacin,continuous treatment for 2 weeks.The clinical efficacy,symptom improvement,inflammatory factor levels,and lung function between the two groups were compared.Result:The total effective rate for treatment of the observation group was 95.00%(38/40),which was higher than 80.00%(32/40)of the control group(P<0.05).The disappearance time of cough was(4.26±0.89)d,the disappearance time of fever was(3.19±0.63)d,and the disappearance time of lung moist rales was(7.21±1.34)d in the observation group,which were shorter than(6.31±1.59),(5.48±1.20),(9.75±1.88)d in the control group,the differences were statistically significant(P<0.05).Before treatment,there were not statistical differences between the two groups in terms of procalcitonin(PCT),C reactive protein(CRP),forced expiratory volume in the first second(FEV1),peak expiratory flow(PEF),and forced vital capacity(FVC)(P>0.05);after treatment,the PCT and CRP of the observation group were(0.84±0.15)ng/mL and(6.20±1.28)mg/L,which were lower than(1.38±0.26)ng/mL,(8.31±1.57)mg/L of the control group,FEV1 was(2.25±0.58)L,PEF was(3.48±0.69)L/s,and FVC was(3.41±0.71)L in the observation group,which were higher than(1.78±0.43)L,(2.69±0.58)L/s,(2.96±0.60)L of the control group,the differences were statistically significant(P<0.05).Conclusion:Bronchoscopy alveolar lavage+local administration of Amikacin can accelerate the regression of symptoms in patients with bronchiectasis and infection,reduce the level of inflammatory factors,and improve lung function.