支气管镜吸痰治疗多重耐药菌呼吸道感染的临床疗效观察.docVIP

精品论文 参考文献 支气管镜吸痰治疗多重耐药菌呼吸道感染的临床疗效观察 绵阳市中心医院 四川绵阳 621000 【摘 要】目的：观察支气管镜吸痰治疗多重耐药菌呼吸道感染的临床效果。 方法：采用随机单盲对照试验，治疗组主要采用支气管镜吸痰治疗措施，对照组主要采用抗生素抗感染治疗措施，疗程7-10 d，分析比较患者临床疗效、影像学改变、痰培养转阴率、不良反应、治疗费用等方面的差异。结果：113例入选病例中，治疗组54例，对照组59例，两组在临床疗效、痰培养转阴率等方面比较，P值分别为0.067、0.071，均gt;0.05，差异无统计学意义。在不良反应、药物费用等方面比较，P值分别为0.042、0.025，均＜0.05，差异有统计学意义。结论：对于多重耐药菌呼吸道轻中度感染患者，支气管镜吸痰与抗生素疗效相似，而不良反应少，值得临床采用。 【关键词】支气管镜；多重耐药菌； 呼吸道感染。 【中图分类号】R768.1 【文献标识码】B 【文章编号】1764-8999（2015）7-0735-02 【Abstract】Objective: To observe the clinical efficacy of suction by bronchoscope in respiratory tract infections by multi-resistant bacteria. Methods: We performed a randomized, single-blinded, controlled clinical trial, treatment group: suction treatment by bronchoscope; control group: anti-infection treatment by antibiotics; treatment for 7-10 d, analysis of comparative clinical efficacy, radiographic improvement, sputum culture negative rate, conversion rate and cost of treatment differences. Results: 113 cases were enrolled, 54 of observer group, 59 of control group; The P values #8203;#8203;were 0.067、0.071 in the two groups for the clinical efficacy, sputum culture negative rate. All of them aregt; 0.05, the difference was not statistically significant. The P values were 0.042,0.025, for adverse reactions and drug costs, lt;0.05, the difference was statistically significant. Conclusion: It is similar of clinical efficacy between bronchoscope suction and antibiotics in patients with mild to moderate respiratory infections by multi-resistant bacteria, the former is fewer adverse reactions. So, it is worthy of adoption to suck by bronchoscope in them. 【Key words】Bronchoscope; Multidrug resistant bacteria; Respiratory tract infections。 多重耐药菌是指对三种及三种以上抗生素耐药的细菌，常见为医院内感染，细菌构成以非发酵革兰氏阴性菌、肠杆菌科细菌和金黄色葡萄球菌等多见；其大多属于条件致病菌，常在免疫力低下、长期住院的患者的呼吸道、尿道及一些植入体内的开放或半开放性管道内（如尿管、气管插管、深静脉置管等）长期定殖；由于这些细菌长期在医院环境内存在，在消毒剂和各种抗菌药物选择压力下，常表现为多重耐药状态，对临床常用的多种抗菌药物耐药；而且耐药基因相互之间可传递或转移，造成耐药基因在不同菌种间传播；在某种情况下这些耐药菌会出现致病状态，表现为不同程度的感染