纤支镜下支气管肺泡灌洗辅助治疗重症肺炎48例疗效观察.PDFVIP

海南医学2013 年7 月第24 卷第13 期 doi:10.3969/j.issn.1003-6350.2013.13.0790 ·论 著· 纤支镜下支气管肺泡灌洗辅助治疗重症肺炎48 例疗效观察 钟祥柱 (广东医学院附属佛山禅城医院呼吸内科，广东 佛山 528031) 【摘要】 目的 观察纤支镜下支气管肺泡灌洗术辅助治疗重症肺炎的临床效果。方法 将90 例重症肺炎患 者随机分为A 组(n=48)与B 组(n=42) ，B 组给予抗感染等支持疗法，A 组在此基础上加用支气管肺泡灌洗术3~5 次， 治疗3 d 后比较两组血氧饱和度与动脉血气分析指标，治疗10 d后比较两组临床疗效。结果 ①治疗3 d 后，A 组患 者SpO 、PaO 、PaCO 改善情况优于B 组，差异具有统计学意义(P0.05) ；②治疗10 d后，A 组显效率(52.1%)与总体有 2 2 2 效率(93.8%)均高于B 组(34.1%、81.0%) ，前者差别具有统计学意义(P0.05) ；③B 组治疗期死亡2 例(4.8%) ，A 组无死 亡病例。结论 常规治疗重症肺炎基础上联合支气管肺泡灌洗能明显提高临床疗效，能有效降低病死率。 【关键词】 支气管肺泡灌洗术；重症肺炎；血气分析；疗效；病死率 【中图分类号】R563.1 【文献标识码】A 【文章编号】 1003—6350(2013) 13—1905—02 Clinical efficacy of fiber bronchoscopic bronchoalveolar lavage in adjuvant treatment of patients with severe pneumonia: a report of 48 cases. ZHONG Xiang-zhu. Department of Respiratory Medicine, Foshan Chancheng HospitalAffiliatedtoGuangdongMedicalCollege,Foshan528031,Guangdong,CHINA 【Abstract 】 Objective To conduct a clinical observation on fiber bronchoscopic bronchoalveolar lavage (BAL) in adjuvant treatment of patients with severe pneumonia. Methods Ninety patients with severe pneumonia were randomly divided into group A (n=46) and group B (n=42). Group B applied conventional treatment, group A was given BAL operation for 3~5 times based on the treatment of group B. Three days later, the blood oxygen satura- tion (SpO ) and arterial blood gas indicators were compared between the two groups. The clinical efficacy was com- 2 pared 10 days later. Results ①Three days after treatment, the improvement of SpO , PaO , PaCO