摘要
目的观察纤维支气管镜吸痰灌洗联合抗生素治疗重症肺部感染的效果及安全性。方法选取2016年1月—2020年10月于江苏省昆山市第二人民医院就诊的重症肺部感染患者60例,按照随机数字表法分为观察组和对照组,每组30例。对照组给予抗生素治疗,观察组在对照组的基础上联合纤维支气管镜吸痰灌洗,2组均治疗7 d。比较2组治疗效果、症状缓解时间、住院时间,治疗前后血清炎性因子、肺通气功能指标、动脉血气分析指标、生活质量评分及不良反应。结果观察组患者的总有效率为96.67%,高于对照组的80.00%(χ^(2)=4.043,P=0.044);观察组患者咳嗽、咯痰、发热缓解时间及住院时间均短于对照组(P<0.01);治疗7 d后,2组患者的血清白介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平及动脉血二氧化碳分压(PaCO_(2))均低于治疗前,第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)、动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))均高于治疗前,且观察组降低/升高幅度大于对照组(P<0.01);治疗7 d后,2组患者的生活质量各项指标评分均高于治疗前,且观察组高于对照组(P<0.01)。2组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论纤维支气管镜吸痰灌洗联合抗生素治疗重症肺部感染的效果较好,可有效控制患者病情,减轻炎性反应,改善患者肺通气功能和动脉血气状况,有利于提升患者生活质量,且不良反应少,安全性良好,值得临床推广应用。
Objective To observe the effect and safety of fiberoptic bronchoscope suction lavage combined with antibiotics in the treatment of severe pulmonary infection.Methods A total of 60 patients with severe pulmonary infection who were treated in the Second People's Hospital of Kunshan,Jiangsu Province from January 2016 to October 2020 were selected.According to the random number table method,they were divided into observation group and control group,30 cases in each group.The control group was treated with antibiotics,and the observation group was treated with fiberoptic bronchoscopy for sputum suction and lavage on the basis of the control group,both groups were treated for 7 days.The treatment effect,symptom relief time,hospital stay,serum inflammatory factors,pulmonary ventilation function indexes,arterial blood gas analysis indexes,quality of life scores and adverse reactions before and after treatment were compared between the two groups.Results The total effective rate of patients in the observation group was 96.67%,which was higher than 80.00% in the control group(χ^(2)=4.043,P=0.044);The cough,expectoration,fever relief time and hospital stay in the observation group were shorter than those in the control group(P<0.01);After 7 days of treatment,serum interleukin IL-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)levels and arterial blood carbon dioxide partial pressure(PaCO_(2))were lower than those before treatment,the forced expiratory volume in 1 second(FEV_(1)),FEV_(1)/forced vital capacity(FVC),arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SpO_(2))were all higher than those before treatment,and the decrease/increase in the observation group was greater than that in the control group(P<0.01);After 7 days of treatment,the scores of various indicators of quality of life in both groups were higher than those before treatment,and the observation group was higher than the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Fiberoptic bronchoscope suction lavage combined with antibiotics has a good effect in the treatment of severe pulmonary infection,can effectively control the patient's condition,reduce inflammatory response,improve the patient's pulmonary ventilation function and arterial blood gas status,and is conducive to improving the patient's quality of life,and adverse reactions few,it has good safety and is worthy of clinical application.
作者
何燕玲
岳佩瑜
周雪玲
徐罕鲤
顾曦
HE Yanling;YUE Peiyu;ZHOU Xueling;XU Hanli;GU Xi(The Second People's Hospital of Kunshan,Jiangsu Province,Kunshan 215300,China)
出处
《临床合理用药杂志》
2022年第16期19-22,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
重症肺部感染
纤维支气管镜
肺泡灌洗
吸痰
抗生素
Severe pulmonary infection
Fiberoptic bronchoscopy
Alveolar lavage
Sputum suction
Antibiotics
