纤支镜下肺泡灌洗联合依替米星局部给药治疗支气管扩张并感染患者疗效观察
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摘要
目的观察纤支镜下肺泡灌洗联合依替米星局部给药治疗支气管扩张并感染患者的临床效果。方法选取2016年7月至2018年6月我院收治的支气管扩张并感染患者160作为研究对象,随机分为对照组(75例)与观察组(85例)。在常规对症及抗感染治疗的基础上,对照组患者给予纤维支气管镜下肺泡灌洗治疗;观察组患者在对照组组治疗基础上,给予依替米星局部给药治疗。治疗2周,比较两组患者的疗效、临床表现、动脉血氧分压(PaO_2)、血氧饱和度(SaO_2)、动脉血二氧化碳分压(PaCO_2)以及并发症发生率。结果观察组患者的治疗总有效率(95.3%)明显高于对照组(84.0%),差异有统计学意义(P<0.05)。观察组患者发热消退时间、咳嗽咳痰改善时间、肺部炎性病灶消失时间均显著短于对照组,差异有统计学意义(P<0.05)。治疗2周后,两组患者的PaO_2、SaO_2、PaCO_2均显著改善,观察组患者的改善情况优于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者的并发症发生率比较,差异无统计学意义(P>0.05)。结论纤维支气管镜下肺泡灌洗联合依替米星局部给药治疗支气管扩张并感染患者临床疗效显著,可显著改善临床症状及血气状况,治疗安全性高,值得推广应用。
Objective To observe the clinical efficacy of bronchoalveolar lavage combined with topical administration of etimicin on patients with bronchiectasis and infection. Methods A total of 160 patients with bronchiectasis and infection admitted to our hospital from July 2016 to June 2018 were selected and randomly divided into the control group(75 cases) and the observation group(85 cases). On the basis of conventional symptomatic and anti-infective treatment, the control group was treated with bronchoalveolar lavage, while the observation group was treated with topical administration of etimicin on the basis of treatment in the control group. After 2 weeks of treatment, the efficacy, clinical manifestation, arterial oxygen partial pressure(PaO_2), oxygen saturation(SaO_2), arterial carbon dioxide partial pressure(PaCO_2) and complications incidence rate were compared between the two groups. Results The total effective rate of treatment in the observation group(95.3%) was significantly higher than that in the control group(84.0%), and the difference was statistically significant(P<0.05). The time of fever subsidence, cough improvement and pulmonary inflammatory lesions disappearance in the observation group were significantly shorter than those in the control group, and the difference was statistically significant(P<0.05). After 2 weeks of treatment, the PaO_2, SaO_2 and PaCO_2 in both groups significantly improved; the improvement in the observation group was better than that in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in complications incidence rate between the two groups during treatment(P>0.05). Conclusion The clinical efficacy of bronchoalveolar lavage combined with topical administration of etimicin on patients with bronchiectasis and infection is prominent. It can significantly improve clinical symptoms and blood gas status; it has high safety and it is worthy of promotion and application.
Objective To observe the clinical efficacy of bronchoalveolar lavage combined with topical administration of etimicin on patients with bronchiectasis and infection. Methods A total of 160 patients with bronchiectasis and infection admitted to our hospital from July 2016 to June 2018 were selected and randomly divided into the control group(75 cases) and the observation group(85 cases). On the basis of conventional symptomatic and anti-infective treatment, the control group was treated with bronchoalveolar lavage, while the observation group was treated with topical administration of etimicin on the basis of treatment in the control group. After 2 weeks of treatment, the efficacy, clinical manifestation, arterial oxygen partial pressure(PaO_2), oxygen saturation(SaO_2), arterial carbon dioxide partial pressure(PaCO_2) and complications incidence rate were compared between the two groups. Results The total effective rate of treatment in the observation group(95.3%) was significantly higher than that in the control group(84.0%), and the difference was statistically significant(P<0.05). The time of fever subsidence, cough improvement and pulmonary inflammatory lesions disappearance in the observation group were significantly shorter than those in the control group, and the difference was statistically significant(P<0.05). After 2 weeks of treatment, the PaO_2, SaO_2 and PaCO_2 in both groups significantly improved; the improvement in the observation group was better than that in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in complications incidence rate between the two groups during treatment(P>0.05). Conclusion The clinical efficacy of bronchoalveolar lavage combined with topical administration of etimicin on patients with bronchiectasis and infection is prominent. It can significantly improve clinical symptoms and blood gas status; it has high safety and it is worthy of promotion and application.
引文
[1] 陈勇,谭经福,廖振辉,等.纤维支气管镜肺泡灌洗联合依替米星局部给药治疗支气管扩张并感染的临床疗效[J].疑难病杂志,2018,17(2):133-136.
[2] 周小果,郑大炜,韩玉辉.依替米星联合支气管肺泡灌洗治疗老年支气管扩张患者感染的临床研究[J].中华医院感染学杂志,2015,11(16):3714-3716.
[3] 林卫涵.纤维支气管镜支气管肺泡灌洗并局部注药治疗支气管扩张合并感染的疗效观察[J].实用心脑肺血管病杂志,2013,21(6):85-86.
[4] 蔡柏蔷,何权瀛,高占成,等.成人支气管扩张症诊治专家共识(2012版)[J].中华危重症医学杂志(电子版),2012,5(5):315-328.
[5] 郑大炜.纤维支气管镜肺泡灌洗治疗支气管扩张合并感染的疗效[J].中国内镜杂志,2015,21(5):491-493.
[6] 戴晓乔,蒋慧,钟平.纤维支气管镜灌洗术治疗支气管扩张合并肺部感染的疗效评价[J].中华全科医学,2017,15(11):1876-1878,1921.
[7] 陈卫强,薛庆亮,李继东,等.纤维支气管镜治疗支气管扩张并感染临床研究[J].西北国防医学杂志,2014,12(2):119-121.
[8] 米日古力·依力哈木,陆瑶,王慧,等.纤维支气管镜下肺泡灌洗治疗支气管扩张合并感染的效果及对血气指标、血清炎症指标水平的影响[J].中国医药导报,2018,15(1):53-56.
[9] 李敏菁,甄国粹,赖其廷,等.支气管肺泡灌洗治疗支气管扩张合并感染临床疗效观察[J].内科,2015,10(1):36-37.
[10] 陈刚,徐永芳,徐长青,等.哌拉西林/他唑巴坦联合依替米星治疗支气管扩张患者感染疗效的分析[J].中华医院感染学杂志,2016,26(9):1970-1972.
[2] 周小果,郑大炜,韩玉辉.依替米星联合支气管肺泡灌洗治疗老年支气管扩张患者感染的临床研究[J].中华医院感染学杂志,2015,11(16):3714-3716.
[3] 林卫涵.纤维支气管镜支气管肺泡灌洗并局部注药治疗支气管扩张合并感染的疗效观察[J].实用心脑肺血管病杂志,2013,21(6):85-86.
[4] 蔡柏蔷,何权瀛,高占成,等.成人支气管扩张症诊治专家共识(2012版)[J].中华危重症医学杂志(电子版),2012,5(5):315-328.
[5] 郑大炜.纤维支气管镜肺泡灌洗治疗支气管扩张合并感染的疗效[J].中国内镜杂志,2015,21(5):491-493.
[6] 戴晓乔,蒋慧,钟平.纤维支气管镜灌洗术治疗支气管扩张合并肺部感染的疗效评价[J].中华全科医学,2017,15(11):1876-1878,1921.
[7] 陈卫强,薛庆亮,李继东,等.纤维支气管镜治疗支气管扩张并感染临床研究[J].西北国防医学杂志,2014,12(2):119-121.
[8] 米日古力·依力哈木,陆瑶,王慧,等.纤维支气管镜下肺泡灌洗治疗支气管扩张合并感染的效果及对血气指标、血清炎症指标水平的影响[J].中国医药导报,2018,15(1):53-56.
[9] 李敏菁,甄国粹,赖其廷,等.支气管肺泡灌洗治疗支气管扩张合并感染临床疗效观察[J].内科,2015,10(1):36-37.
[10] 陈刚,徐永芳,徐长青,等.哌拉西林/他唑巴坦联合依替米星治疗支气管扩张患者感染疗效的分析[J].中华医院感染学杂志,2016,26(9):1970-1972.