床旁纤支镜治疗重型颅脑疾患并肺部感染的临床研究.docVIP

strongstone@ 中华网 简介不全。摘要一般为200~300字。表1为两种不同的统计学方法，应分开制表。见文内红字，将各统计结果列入各表中。如x2=? T=? 床旁纤支镜治疗重型颅脑疾患并肺部感染的临床研究 汤石林 符晖 赵正亮 南华大学附一医院ICU, 衡阳，421001 摘要：目的 评价床旁纤维支气管镜（纤支镜）在重型颅脑疾患并肺部感染中的疗效。方法 2008年4月~2011年3月对入住我院ICU明确诊断为颅脑疾患并肺部感染的145例患者进行回顾性分析，根据是否采用纤支镜分为纤支镜组（75例）和对照组（70例），比较两组的病原菌检出率、病原菌类型、治疗7天和14天后临床肺部感染评分（CPIS）、机械通气时间、ICU停留时间、ICU死亡率等。结果 纤支镜组肺泡灌洗液病原菌检出率明显高于对照组（82.67% vs 47.14%, P0.05）；治疗7天和14天后，纤支镜组的CPIS较对照组明显下降（3.4±0.6 vs 5.1±1.3，1.8±0.5 vs 3.0±1.0，P0.05）。纤支镜组机械通气时间，ICU停留时间和ICU死亡率均较对照组明显降低（9.4±1.9 vs 14.4±2.3，6.4±2.2 vs 9.5±2.6，6.67 vs 21.42，P0.05）。纤支镜组无明显的不良反应。结论 纤支镜治疗在重型颅脑疾患并肺部感染中安全有效，能改善此类患者的预后，有较高的临床应用价值。 关键字：重型颅脑疾患，肺部感染，纤维支气管镜，支气管肺泡灌洗术 ------------------------------------------------------------------------------- [通讯作者]汤石林，主治医师，硕士， E-mail：strongstone@，Tel: 0734-8279358 Clinical study of the effect of bedside fiberoptic bronchoscope in treatment of severe brain disorders with infection of the lungs Shi-Lin TANG Hui Fu Zheng-Liang Zhao Intensive Care Unit of the First Affiliated Hospital, University of South China, Hengyang 421001, China Abstract Objective To evaluate the therapeutic effect of the bedside fiberoptic bronchoscope in severe brain disorders complicated by infection of the lungs. Methods: 145 patients, who were hospitalized for severe brain disorders at department of ICU in our hospital from April 2008 to March 2011, were randomly divided into two groups according to whether use of the bedside fiberoptic bronchoscope group including 75cases and the control group including 70cases. Bacteria type,the detection rate of the pathogen, the clinical pulmonary infection score (CPIS) after 7 days and 14 days of treatment, aeration time, residence time and mortality in ICU were compared between two groups. Results: The detection rate of alveolar fluid pathogens in fiberoptic bronchoscope group was significantly higher than control group（82.67% vs 47.14%, P0.05）. The CPIS of 14 days and 28days after treatment were significantly decreased in fiberoptic br