摘要
目的探究纤维支气管镜灌洗联合抗菌药物对重症肺炎患者临床疗效及呼吸力学指标的影响。方法选取2016年3月~2018年1月衡水市第三人民医院收治的重症肺炎患者136例,按照入院顺序随机分为对照组(n=68)及观察组(n=68),两组均给予常规抗感染治疗,对照组同时行常规灌洗吸痰治疗,观察组行联合纤维支气管镜灌洗治疗。治疗1周后,统计比较两组临床疗效、症状改善情况及呼吸力学指标变化。结果与治疗前比较,治疗后1周两组患者肺部感染评分(CPIS)均显著降低,且观察组退热时间、机械通气时间均较对照组显著缩短,白细胞计数(WBC)及CPIS均较对照组显著降低,差异有统计学意义(P<0.01);治疗后1、4h两组患者气道峰压(PIP)、气道阻力(Raw)、呼吸做功(WOB)均逐渐降低,且观察组低于对照组(P<0.01);两组动态顺应性(Cdyn)逐渐升高,且观察组显著高于对照组,差异有统计学意义(P<0.01)。治疗后1周,观察组临床总有效率为88.24%,较对照组的73.54%显著升高,差异有统计学意义(P<0.05)。结论纤维支气管镜灌洗联合抗感染药物治疗可有效缓解重症肺炎患者炎性症状,改善其呼吸力学指标,临床疗效较常规治疗显著提高。
Objective To explore effect of fiberoptic bronchoscopy combined with anti-infective medicine on clinical efficacy and respiratory mechanics indexes for severe pneumonia patients. Methods A total of 136 cases severe pneumonia patients in our hospital were selected and divided into control group(n=68) and observation group(n=68) according to admission order,2 groups were treated with routine anti-infective therapy,and control group was treated with conventional irrigation and suction treatment,while observation group was treated combined with fiberoptic bronchoscopy irrigation treatment. 1 week after treatment,the clinical efficacy in 2 groups were statisticsed;the improvement of clinical symptoms in 2 groups were recorded and compared;the changes of respiratory mechanics indexes in 2 groups before and after treatment were detected and compared. Results Compared with before treatment,CPIS in 2 groups 1 week after treatment decreased significantly (P < 0.01),and the antipyretic time,mechanical ventilation time in observation group shortened compared with control group(P < 0.01),WBC and CPIS in observation group decreased compared with control group(P < 0.01);compared with before treatment,PIP,Raw and WOB from 1 h to 4 h after treatment in 2 groups decreased gradually,Cdyn increased gradually,and the difference between 2 groups was significant 1,4 h after treatment(P < 0.01);the clinical total efficacy of observation group was higher than control group(P < 0.05). Conclusion Fiberoptic bronchoscopy irrigation combined with anti-infective medicine can ease the inflammatory symptoms of severe pneumonia patients,improve the respiratory mechanics indexes,the clinical efficacy enhances compared with conventional treatment.
作者
曹亚伟
周保仓
袁巨平
刘灿
Cao Yawei;Zhou Baocang;Yuan Juping(Department of Pulmonary Section,Hengshui Third People's Hospital,Hengshui 053000,China)
出处
《中华保健医学杂志》
2019年第4期323-325,共3页
Chinese Journal of Health Care and Medicine
基金
衡水市重点研发计划项目(2017014013C-40)
关键词
重症肺炎
纤维支气管镜
抗感染
呼吸力学
Severe pneumonia
Fiberoptic bronchoscopy
Anti-infective
Respiratory mechanics
