摘要
目的探讨支气管镜肺泡灌洗术治疗难治性肺部感染的疗效和不良反应。方法将217例符合入选标准的患者随机分为2组,对照组107例,采用常规治疗;灌洗组110例,在常规治疗基础上,加用床旁支气管镜肺泡灌洗术,每周2～3次,连续2周。观察2组患者临床有效率、发热时间、X线胸部病灶吸收时间、平均住院日、细菌清除率及灌洗前后血气变化。结果灌洗组临床有效率和细菌清除率显著高于对照组(P<0.01),发热时问、X线胸部病灶吸收时间和平均住院日均明显短于对照组(P<0.01),灌洗组灌洗后24h PaO_2、SaO_2、氧合指数(PaO_2/FiO_2)明显高于灌洗前(P<0.01),PaCO_2明显低于灌洗前(P<0.01),灌洗过程中患者未发生明显不良反应。结论采用床旁支气管镜肺泡灌洗术对难治性肺部感染具有明显的疗效,可显著提高治愈率,缩短病程,且较安全。
Objective To explore the clinical effect and safety of bronchoalveolar lavage（BAL） by bronchoscopy in the treatment of refractory pulmonary infection.Methods 217 patients who reached the enrolling criteria were randomly divided into BAL group（110 cases） and control group（107 cases）.The traditional therapy were only given to control group,besides traditional therapy,bronchoscopic bronchoalveolar lavage were given to BAL group at twice to three times a week for 2 weeks.The clinical effect,fever duration,findings of X ray films,admission time,bacterial clearance ratio and lab test pre/ after treatment.Results There were significant differences in cure rate,bacterial clearance,fever duration,X ray changed hospitalization time between two groups（P0.01 ）.PaO_2 and oxygenation index（PaO_2/FiO_2 ） after BAL of 24h were obviously higher than those before BAL（P0.01）,and the reverse results were found in PaCO_2（P0.01 ）.No side effects were found during therapy.Conclusion BAL in the treatment of refractory pulmonary infection was safe and effective.It was worthy of being recommended in clinical practice.
出处
《疑难病杂志》
CAS
2011年第11期826-828,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
肺部感染
难治性
支气管镜
肺泡灌洗术
临床疗效
Pulmonary infection
refractory
Bronchoscopy
Bronchoalveolar lavage
Clinical effect
