经纤维支气管镜引导肺内留置导管注药治疗高龄肺脓肿的应用价值

目的探讨肺内留置导管注药治疗高龄肺脓肿的应用价值。方法60例诊断肺脓肿的高龄患者,随机分为三组,内科常规治疗联合肺内留置导管介入治疗组18例,联合纤支镜下间断局部注药组22例,单纯内科治疗组20例;肺内留置导管组应用纤支镜导入法,留置导管,用头孢哌酮/舒巴坦0.75g加生理盐水10mI自导管注入,2~3次/d。结果肺内留置导管治疗组:治愈16例(88·9%),有效2例(11.1%),总有效率100%;纤支镜下间断注药组:治愈19例(86·4%),有效2例(9.1%),无效1例,总有效率95.5%;内科常规治疗组:治愈9例(45.0%),有效4例(20.0%),无效4例,总有效率65.0%,其中死亡3例;肺内留置导管组与纤支镜下间断注药组,两组疗效无显著性差异(P>0·05),而肺内留置导管组及纤支镜间断注药组,疗效明显优于内科常规治疗组(P<0.01);肺内留置导管组体温均恢复正常,较纤支镜间断注药组明显缩短,两组相比有显著性差异(P<0.05)。结论纤支镜下肺内留置导管治疗高龄肺脓肿可缩短疗程,减少医疗费用,安全性好,可提高治愈率,并发症少。

Application Value of Injecting Drugs with Indwelling Catheter in Lung through Fibrobronchoscope on Senile Patients of Lung Abscess

Objective To eplore the appl ic ation value of injecting drugs via indwelling catheter in lung on senile patient s with lung abscess. Methods Sixty senile patients of lung abscess were divided into three groups at random. The first group (18 cases) was treated by medical routi ne methods combined with indwelling cathether in lung, the second one (22 cases) additionally by locally discontinuous injection of drugs through fibrobronchosc ope, and the third one (20 cases) only by simple medical therapy. Fibrobronchosc ope was used in the group of indwelling catheter in lung. Cefoperazon/sulbactam sodium (0.75) plus normal saline (10ml) was injected through catheter twice or t hrice per day. Results In the first group with indwelling catheter in lung, 16 cases were cured (88.9%), and two cases were effective (11.1%). The total effic acy rate was 100%. In the second group with discontinuously injectiong drugs thr ough fibrobronchoscope, 19 cases were cured (86.4%), two cases were effective (9 .1%), and one case was noneffective. The total efficacy rate was 95.5%. And in t he third group, only nine cases were cured (45.0%), four cases were effective (9 .1%), and four cases were noneffectiv (of them, three died). There was no signif icant difference in therapeutic effect between the former two groups (P>0.05 ), but their therapeutic effects were better than that of the third group (P <0.01). The recovery time of body temperature to normal was shorter in the first group than in the second group (P<0.05). Conclusion Senile patients of lung abscess, treated by indweeli ng catheter in lung through fibrobronchoscope, can benefit from shorter course o f treatment and higher cure rate, as well as few complications.