纤支镜灌洗治疗多重耐药菌所致重症肺炎的临床观察

Clinical Observation of Bronchoscopy Lavage in the Treatment of Severe Pneumonia Caused by Multi-drug Resistant Bacteria

目的观察纤支镜灌洗治疗多重耐药菌感染所致重症肺炎的临床疗效。方法选取53例确诊为多重耐药菌感染所致的重症肺炎患者,随机分成两组。对照组26例常规静脉使用敏感抗生素,并予对症治疗及支持治疗;治疗组27例在上述治疗的基础上应用纤支镜吸痰并进行肺灌洗,每周2~3次。疗程均为14d,观察治疗前后两组患者体温、痰量、呼吸困难、肺部啰音、血气分析、血象、胸部CT以及肺炎严重程度评分(PSI评分)和急性生理和慢性健康评分(APACHEⅡ评分)的变化。结果治疗组患者在体温,痰量,呼吸困难,肺部啰音,血象,胸部CT以及PSI评分和APACHEⅡ评分方面较对照组均有明显改善(P<0.05)。结论使用纤支镜灌洗治疗多重耐药菌感染所致的重症肺炎疗效显著。

Objective To observe the clinical effect of bronchoscopy lavage in the treatment of severe pneumonia caused by multi-drug resistant bacteria( MDR) . Methods 53 patients diagnosed as severe pneumonia caused by MDR were selected and divided into two groups randomly,26 patients of the control group were used sensitive antibiotic in vein routinely,and gave the symptomatic and support treatment for the illness;27 patients of the treatment group were used the bronchoscope drawing sputum and lung lavage on the foundation of the control group,2~3 times one week,the course of treatment are all 14 days. Observation on the two groups of patients before and after the treatment in the temperature,the amount of sputum, dyspnea,rale in the lungs,blood gas analysis,the hemogram and the chest CT changes,pneumonia severity index score( PSI scores) ,Acute Physiology And Chronic Health Evaluation Ⅱ(APACHEⅡ scores). Results The patients of treatment group in the temperature,the amount of sputum, dyspnea,pulmonary rales,hemogram,chest CT,and PSI scores and APACHEⅡ scores had more significant improvement than the control group (P<0. 05). Conclusion Bronchoscopy lavage in the treatment of severe pneumonia caused by MDR had obvious effects.