纤维支气管镜与机械通气联合救治肝移植术后重症肺部感染

目的 探讨纤维支气管镜(纤支镜)与机械通气联合救治肝移植术后肺部重症感染的疗效.方法 回顾分析福州总院肝胆病中心2000年1月至2007年1月肝移植术后并发重症肺部感染的46例病人采用联合机械通气,行纤支镜检查、取痰堵养、吸痰、支气管肺段灌洗等治疗,观察治疗前后动脉血气分析结果的变化及标本病原学检测和药敏实验.结果 治疗后动脉血气分析中pH,PaO2.PaCO2,SaO2指标明显好转(P＜0.05),吸出分泌物培养阳性检出率为76.1%(35/46).治疗有效率为91.3%.结论 纤支镜与机械通气联合应用救治肝移植术后重症肺部感染,有助于确定致病菌,清除气道分泌物、局部灌洗增强抗感染效果.

Bronchoecopy in combination with mechanical ventilation to save patients with severe pulmonary infection following liver transplantation

Objective To explore the effect of bronchoscopy in combination with mechanical ventilation to save the patients with severe pulmonary infection following liver transplantation. Meth-ods A total of 46 patients with severe pulmonary infection after liver transplantation in our center from 2000 to 2007 were treated with bronchoscopy in combination with mechanical ventilation, including drawing spittoon, bacterial pneumonia of the spittoon, bronchoscopic lavage. Following treatment,the changes of parameters of arterial blood gas (pH, PaO2, PaCO2, SaO2) were compared. Results Following treatment, the parameters of arterial blood gas(pH, PaO2, PaCO2, SaO2) in the treatment group were improved significantly (P＜0.05). Conclusion The treatment possesses the advantages of finding pathogenic bacteria and clearing away secretion in the tracheas to have better local anti- in-flammatory effects.