CAJ | 학술논문

目的：观察纤支镜灌洗治疗多重耐药菌感染所致重症肺炎的临床疗效。方法选取53例确诊为多重耐药菌感染所致的重症肺炎患者,随机分成两组。对照组26例常规静脉使用敏感抗生素,并予对症治疗及支持治疗；治疗组27例在上述治疗的基础上应用纤支镜吸痰并进行肺灌洗,每周2~3次。疗程均为14d,观察治疗前后两组患者体温、痰量、呼吸困难、肺部啰音、血气分析、血象、胸部CT以及肺炎严重程度评分( PSI评分)和急性生理和慢性健康评分( A-PACHEⅡ评分)的变化。结果治疗组患者在体温,痰量,呼吸困难,肺部啰音,血象,胸部CT以及PSI评分和APACHEⅡ评分方面较对照组均有明显改善(P<0．05)。结论使用纤支镜灌洗治疗多重耐药菌感染所致的重症肺炎疗效显著。
목적：관찰섬지경관세치료다중내약균감염소치중증폐염적림상료효。방법선취53례학진위다중내약균감염소치적중증폐염환자,수궤분성량조。대조조26례상규정맥사용민감항생소,병여대증치료급지지치료；치료조27례재상술치료적기출상응용섬지경흡담병진행폐관세,매주2~3차。료정균위14d,관찰치료전후량조환자체온、담량、호흡곤난、폐부라음、혈기분석、혈상、흉부CT이급폐염엄중정도평분( PSI평분)화급성생리화만성건강평분( A-PACHEⅡ평분)적변화。결과치료조환자재체온,담량,호흡곤난,폐부라음,혈상,흉부CT이급PSI평분화APACHEⅡ평분방면교대조조균유명현개선(P<0．05)。결론사용섬지경관세치료다중내약균감염소치적중증폐염료효현저。
Objective To observe the clinical effect of bronchoscopy lavage in the treatment of severe pneumonia caused by multi-drug resistant bacteria( MDR) . Methods 53 patients diagnosed as severe pneumonia caused by MDR were selected and divided into two groups randomly,26 patients of the control group were used sensitive antibiotic in vein routinely,and gave the symptomatic and support treatment for the illness;27 patients of the treatment group were used the bronchoscope drawing sputum and lung lavage on the foundation of the control group,2~3 times one week,the course of treatment are all 14 days. Observation on the two groups of patients before and after the treatment in the temperature,the amount of sputum, dyspnea,rale in the lungs,blood gas analysis,the hemogram and the chest CT changes,pneumonia severity index score( PSI scores) ,Acute Physiology And Chronic Health Evaluation Ⅱ(APACHEⅡ scores). Results The patients of treatment group in the temperature,the amount of sputum, dyspnea,pulmonary rales,hemogram,chest CT,and PSI scores and APACHEⅡ scores had more significant improvement than the control group (P<0. 05). Conclusion Bronchoscopy lavage in the treatment of severe pneumonia caused by MDR had obvious effects.