纤维支气管镜肺泡灌洗术治疗感染性肺炎的临床分析

目的 评价纤维支气管镜阿米卡星肺泡灌洗术对ICU多重耐药鲍曼不动杆菌感染性肺炎干预后的临床疗效.方法 将诊断为多重耐药鲍曼不动杆菌感染相关肺炎的患者随机分为对照组和治疗组,对照组给予常规药物肺泡灌洗治疗,治疗组给予阿米卡星肺泡灌洗治疗,治疗结束后,比较治疗组治疗前后、治疗组与对照组的常用评价指标以及CPIS评分的变化特点,同时评价其疗效.结果 R、HR、P02、PCO2、CRP、PCT、WBC以及CPIS评分治疗组治疗后与治疗前相比,治疗组与对照组相比,第1天、第3天差异有统计学意义（P＜0.05）,第7天及第14天则差异无统计学意义（P＞0.05）;治疗后,对照组在治疗第7天有1例转阴,治疗组在第1天和第3天分别有1例转阴.结论 经纤维支气管镜阿米卡星肺泡灌洗治疗ICU多重耐药鲍曼不动杆菌感染相关性肺炎,能在近期使得患者临床症状改善,同时也好于其他常用的药物,有一定的临床应用价值,但其远期治疗效果不明显,需进一步研究改善。

Clinical Retrospective Analysis of Multi-drug Resistant Acinetobacter baumannii Infections Pneumonia after Fiberoptic Bronchoscopy and Bronchoalveolar Lavage with Amikacin in ICU

Objective This study was aimed to evaluate the clinical efficacy of multi-drug resistant Acinetobacter baumannii infections pneumonia after fiberoptic bronchoscopy and bronchoalveolar lavage with amikacin in ICU. Methods Patients diagnosed with multi-drug resistant A. baumannff infections pneumonia were randomly divided into control group and treatment group. The control group received conventional treatment, and the treatment group received bronchoalveolar lavage with amikacin. After treatment, the evaluation indicators and changes of CPIS scores were compared between the two groups, and their clinical efficacies were evaluated. Results Compared with the control group, there were significant differences in seven indicators including R, HR, PO_2, PCO_2, CRP, PCT and WBC, and CPIS score at the 1st and the 3rd days after treatment in the treatment group （P〈 0.05）, while no significant differences at the 7th and 14th days （P〉 0.05） . After treatment, 1 case in the control group became negative after 7 days in control group, while 2 cases in the treatment group became negative after 1 day and 3 days, respectively. Conclusion Fiberoptic bronchoscopy and bronchoalveolar lavage with amikacin can be used to treat the multi-drug resistant therapeutic method can improve clinical symptoms in the A. baumannii infections associated pneumonia in ICU. The short time, and its efficacy is better than other common medicines. It has a certain clinic application value, but its long-term therapeutic effect is not obvious, need to be improved.