CAJ | 학술논문

目的：研究经支气管镜肺段灌洗联合病种球蛋白治疗多重耐药菌肺炎的疗效。方法选择50例经病理学检查确认为多重耐药菌肺炎患者为研究对象，采用临床肺部感染评分法，均符合医院获得性肺炎和呼吸机相关性肺炎的诊断标准。将50例患者随机分作联合组和对照组各25例，均实行抗感染治疗、营养支持，每日注射丙种球蛋白。联合组在上述基础上采用支气管镜肺段灌洗。观察项目：①临床指标：住院天数、肺部体征开始消退时间。②出院后每3个月进行随访。结果联合组在痰量，动脉血氧分压、呼吸频率、体温等方面均得到明显改善（P＜0．05）；疗效明显优于对照组（P＜0．05），联合组平均住院日为（21．4±5．6）天，对照组为（28．6±7．3）天，P＜0．05。联合组与对照组肺部体征开始消退天数分别为（7．31±1．57）天和（10．26±3．41）天，存在统计学差异（ t＝－2．415，P＜0．05）。结论经支气管镜肺段灌洗联合丙种球蛋白治疗多重耐药菌肺炎疗效肯定，操作简便，使用安全，具有较高的临床应用价值。
목적：연구경지기관경폐단관세연합병충구단백치료다중내약균폐염적료효。방법선택50례경병이학검사학인위다중내약균폐염환자위연구대상，채용림상폐부감염평분법，균부합의원획득성폐염화호흡궤상관성폐염적진단표준。장50례환자수궤분작연합조화대조조각25례，균실행항감염치료、영양지지，매일주사병충구단백。연합조재상술기출상채용지기관경폐단관세。관찰항목：①림상지표：주원천수、폐부체정개시소퇴시간。②출원후매3개월진행수방。결과연합조재담량，동맥혈양분압、호흡빈솔、체온등방면균득도명현개선（P＜0．05）；료효명현우우대조조（P＜0．05），연합조평균주원일위（21．4±5．6）천，대조조위（28．6±7．3）천，P＜0．05。연합조여대조조폐부체정개시소퇴천수분별위（7．31±1．57）천화（10．26±3．41）천，존재통계학차이（ t＝－2．415，P＜0．05）。결론경지기관경폐단관세연합병충구단백치료다중내약균폐염료효긍정，조작간편，사용안전，구유교고적림상응용개치。
Objective To study the effects of bronchoscope pulmonary segment lavage in combination with intrave -nous immunoglobulin in the treatment of multidrug resistant pneumonia .Methods A total of 50 patients with multidrug resistant pneumonia confirmed by pathological examination were selected as the subjects .Clinical Pulmonary Infection Score was adopted as the diagnostic criterion for hospital acquired pneumonia and ventilator associated pneumonia .The patients were randomized into the combination group and control group , both of which received conventional treatments such as anti-infection and nutritional support , as well as injection of intravenous immunoglobulin ( IVIG).On the basis above , the combination group also received bronchoscope pulmonary segment lavage .The content of observation was as follows:①clinical indicators:hospital stay , the time when pulmonary signs began to disappear;②follow-up observa-tion:follow-up visits were performed every 3 months after discharge , the content of which included clinical manifesta-tion and signs.Results Patients who received bronchoscope pulmonary segment lavage showed significantly decreased body temperature , significantly reduced sputum volume , and significantly improved respiratory rate , PaO2 and chest X-ray ( P<0.05 );the combination group showed significantly better effects ( P<0.05 ) , and the average hospital stay of the combination group and control group was (21.4 ±5.6)d and (28.6 ±7.3)d respectively, showing significant differ-ence (t=-2.164,P<0.05).The time when pulmonary signs began to disappear was (7.31 ±1.57)d and (10.26 ± 3.41)d respectively, showing significant difference (t=-2.415,P<0.05).Conclusions Bronchoscope in combina-tion with IVIG has certain effects on multidrug resistant pneumonia , which is a safe and simple treatment with high clini-cal application value .