支气管肺泡灌洗治疗肺炎合并结构性肺病患者的临床分析

目的探讨支气管肺泡灌洗对肺炎合并结构性肺病且咳痰困难患者的临床疗效。方法将82例肺炎合并结构性肺病且咳痰困难的患者根据是否同意支气管肺泡灌洗分为对照组和治疗组。对照组给予静脉应用抗生素、化痰、平喘及吸痰管吸痰等常规治疗;治疗组在常规治疗的基础上加用支气管肺泡灌洗治疗。比较两组治疗后第(3±1)天的动脉血氧合指数(PO2/Fi O2)、外周血白细胞总数(WBC)、中性粒细胞绝对计数(N)及第(7±1)天的肺部炎性病灶吸收情况和体温转正常时间、平均住院天数、治愈率、病死率等变化。结果治疗后第(3±1)天治疗组的PO2/Fi O2升高、外周血WBC、N降低明显优于对照组(P0.05),治疗后第(7±1)天治疗组X射线胸片显示的肺部炎性病灶较对照组明显吸收(P0.05),治疗组体温转正常时间明显短于对照组(P0.05),治疗组的平均住院天数明显短于对照组(P0.05),治疗组的治愈率明显高于对照组(P0.05),两组病死率差异无统计学意义(P0.05)。结论支气管肺泡灌洗是肺炎合并结构性肺病且咳痰困难患者安全、有效的治疗手段。

Analysis of effects on broncho-alveolar lavage in patients with pneumonia complicated structural lung disease

Objective To analyses the effects on broncho-alveolar lavage (BAL) in patients with pneumonia complicated structural lung disease. Methods 82 patients who suffering from pneumonia complicated structural lung disease in our hospital from June 2012 to June 2014 were selected and divided into the control group (55 cases) and the experimental group (27 cases),which according to accepting or not accepting BAL. Control group were given routine treatment,such as antibiotics,sputum suction,while the experimental group accepted BAL on the basis of routine treatment. The white blood cell (WBC),neutrophil number (N) in peripheral blood and the arterial blood PO2/ FiO2 were test at the third day after treatment, and the chest radiography was done at the seventh day. The time of their body temperature reaching normal,inpatient time and mortality were also recorded. Results After three days treatment,the total number of WBC and N in peripheral blood of the experimental group was decreased significantly than that of the control group (P < 0.05),and PO2 / FiO2 of the experimental group was increased significantly than that of the control group (P < 0.05);The time of body temperature reaching normal and inpatient time were were significantly shorter in the experimental group than in the control group (P < 0.05). The results of chest radiography showed a faster absorption of the inflammation in lung in the experimental group than the control group(P<0.05). There was no significant difference of mortality rate between both groups (P > 0.05). Conclusion Broncho-alveolar lavage (BAL) is a high effective and safe therapeutic method for patients with pneumonia complicated structural lung disease.