经纤维支气管镜介入治疗重症肺炎34例临床分析

目的:探讨经纤维支气管镜介入病灶灌注对重症肺炎的治疗效果及其安全性。方法:将2010年1月至2013年6月我院收治的重症肺炎患者68例随机分为对照组和实验组各34例,对照组应用克倍宁1.0静滴,q12h,共5天,实验组在对照组治疗的基础上应用纤维支气管镜插入病灶肺段支气管,灌注左氧氟沙星400mg,qd,共5天。比较两组的临床疗效、细菌学清除率及不良反应。结果:实验组临床有效率为94.1%,细菌清除率为88.0%,均明显高于对照组的76.5%和69.6%(P均0.05);实验组的不良反应发生率8.8%和对照组5.9%(P0.05)无明显差异。结论:经纤维支气管镜介入感染病灶支气管内灌注药物对重症肺炎的疗效优于常规治疗,且无明显不良反应,建议推广应用。

Clinical Analysis of 34 Patients with Severe Pneumonia Treated by Bronchoscopic Interventional Therapy

Objective：To explore the curative effect and the safety of patients with severe pneumonia treated by bronchoscopic interventional focal perfusion. Methods：68 patients with severe pneumonia were randomly divided into control group and experimental group from Jan 2010 to Jun 2013, and each group was 34 cases. The control group was treated by Panipenemand Betamipron lg, ql2h,intravenous drip for 5 days, while the experimental group was based on the control group therapy and treated by interventional bronchoscopy to insert focal segmental bronchi and infusion of levofloxacin 400mg, QD for 5 days. The clinical and bacteriological efficacy and adverse reactions were compared between the two groups. Results：The clinical effective rate and the bacterial clearance rate in the experimental group was 94.1% and 88.0%, while in the control group was 76.5% and 69.6% （both P 〈 0.05）. The incidence of adverse reactions was 8.8% in the experimental group and 5.9% in the control group （P 〉 0.05）. Conclusion：The infection drug perfusion lesion bronchus on severe pneumonia curative effect is better than that of conventional treatment of fiberoptic bronchoscopic interventional, and no obvious adverse reactions.It is worthy of popularization and application.