摘要
目的评价纤维支气管镜在诊断和治疗难治性肺炎中的临床应用价值。方法将2010年6月至2012年6月经胸片或CT确诊为难治性肺炎60例患者,随机分为对照组及治疗组。全部患者给予常规的平喘祛痰及其必要的基础病治疗外。对照组采用经验性或根据药敏结果选用抗感染药物,同时加用体位引流、解除支气管痉挛、氧疗和基础病治疗等治疗措施。治疗组在对照组治疗的基础上加用纤维支气管镜技术,根据镜下所见,在病变部位选择做局部冲洗、吸痰、细菌学检查、注药及支气管肺泡灌洗等。结果治疗组总有效率为86.7%,对照组为46.7%,两者比较差异有显著性(P<0.05),两组显效率及有效率比较差异无显著性(P>0.05)。另对照组16例无效者给予纤支镜治疗,显效增加5例,有效增加6例,5例无效,其中3例为支气管肺癌伴阻塞性肺炎,1例为肺囊肿反复感染,1例为肺结核感染;治疗组无效4例,有3例为支气管内膜癌,1例为肺结核。结论纤维支气管镜技术是诊治难治性肺炎的一种非常有效的措施,对难治性肺炎应尽早行纤支镜检查,争取尽快明确诊治,避免误诊、误治,提高难治性肺炎治愈率。
Objective To evaluate the clinical significance of bronchofiberscopy in diagnosis and treatment of patients with refractory pneumonia.Methods A total of 60 patients with refractory pneumonia failed to respond to routine antibiotic therapy in this hospital during June 2010 to June 2012 were diagnosed by chest X-ray films and CT scanning,and they were randomly divided into 2 groups： trial group and control group.Patients in trial group were examined and treated with bronchofiberscopy.Patients in control groups refused to accept bronchofiberscopy were treated with traditional therapy.Results The total effective rate of trial group was significantly higher than that of control group（86.7% vs 46.7%,P 0.05）.The difference in effective rate was not significant between these two groups（P 0.05）.Conclusion The application of bronchofiberscopy in diagnosis and treatment of patients with refractory pneumonia is effective and safe.The technique of bronchofiberscopy should be applied in treatment of patients with refractory pneumonia,and it is worthy to be popularized.
出处
《临床和实验医学杂志》
2013年第11期881-882,884,共3页
Journal of Clinical and Experimental Medicine
关键词
难治性肺炎
维支气管镜
诊断
治疗
Refractory pneumonia
Bronchofiberscope
Diagnosis
Treatment
