经纤维支气管镜糜蛋白酶灌洗治疗感染性肺不张20例

摘要：目的 寻找一种安全有效的治疗感染性肺不张的方法。方法 本院收住院38例患者。男，21例，女17例；年龄27~73岁，病程4~12d，均经CT证实为肺不张，且经纤支镜除外其它疾病所致。分为对照组、靡蛋白酶灌洗组。对照组18例在纤支镜下使用生理盐水灌洗和抗感染对症治疗。靡蛋白酶灌洗组20例，将靡蛋白酶稀释浓度为0.5mg/ml，2ml/次，在纤支镜下分次灌注到炎性肺不张处，其他治疗同对照组。两组均每天复查胸部X线片。结果 对照组治愈11例，好转7例，靡蛋白酶灌洗组治愈18例，好转2例。靡蛋白酶灌洗组的治愈率（90%）显著高于对照组（61.1%）(P <0.05)。结论 经纤支镜靡蛋白酶灌洗更能适应于感染性肺不张的治疗。

Using waste proteinase to lavage through fiberbronchoscope to treat the infectious patchy atelectasis

Abstract] Objective To seek a safe and sound way to treat the infectious patchy atelectasis. Methods Thirty-eight cases of this disease were observed in our hospital.Male: 21 cases Female: 17cases. the range of age: 27 to 73 the couse of disease : 4 to 12 days, confirmed to be patchy atelectasis by CT and not caused by fiberbronchoscope.The cases can be divided into the contrast group and waste proteinase group.18 cases of the contrast group are lavaged by normal saline and treated by anti-infection. For 20 cases of waste proteinase lavaging group ,we dilute waste proteinase to 0.5mg/ml，and lavage it to inflammatory patchy atelectasis 2ml per time through fiberbronchoscope and the following treatment will be the same as the former group. Every day we countercheck the X-ray picture of the chest of the two groups. Results For contrast group, 11 patients recovered their health and 7 patients were getting better than before. For the waste proteinase lavaging group ,18 patients were cured and 2 patients were getting better than before. The cure rate of the waste proteinase lavaging group （90%）is dramatically higher than the former group （61.1%）(P <0.05) Conclusions The method of waste proteinase lavaging through fiberbronchoscope is more suitable to treat infectious patchy atelectasis.