经纤维支气管镜肺泡灌洗联合局部给药治疗支气管扩张并感染的疗效分析

目的 观察经纤维支气管镜（纤支镜）支气管肺泡灌洗（BAL）联合局部给药治疗支气管扩张并感染的疗效。方法 将2010年7月-2014年6月我院收治的81例支气管扩张并感染患者随机分为对照组（40例）和治疗组（41例）,对照组给予常规内科抗感染治疗及对症处理,治疗组在对照组基础上给予经纤支镜反复BAL和局部注药,比较两组的临床疗效、临床症状缓解时间、平均住院时间、动脉血气分析、肺功能指标。结果 治疗组临床疗效明显好于对照组（P〈0.05）,治疗组临床症状缓解时间和平均住院时间与对照组相比明显缩短（P〈0.05）。两组治疗前血气指标PaO2（mmHg）、PaO2/FiO2、SaO2（%）无显著差异（P〉0.05）,治疗后两组血气指标明显优于治疗前（P〈0.05）,治疗组治疗后的血气指标与对照组治疗后相比明显上升（P〈0.05）。两组治疗前肺通气功能各项检测指标（VC、FEV1、FEV1%、V50、MVV）无显著性差异（P〉0.05）,治疗组治疗后各项检测指标明显改善（P〈0.05）。结论 经纤支镜BAL联合局部注药治疗支气管扩张并感染安全、可靠、疗效确切,有临床应用价值。

Curative effect analysis of bronchoalveolar lavage and local administration by fiberoptic bronchoscopy in the bronchiectasis with infections

Objective To observe the therapeutic effect of bronchoalveolar lavage （BAL） and local administration by fiberoptic bronchoseopy （FB） in the bronchieetasis with infections. Methods 81 eases of bronchieetasis with infections in our hospital from Jul 2010 to Jun 2014 were randomly divided into control group （40 cases） and treatment group （41 eases）, the control group were given routine internal anti-infection medicine and symptomatic treatment, on this basis, the treatment group were given repeatedly BAL and local administration by fiberoptic bronchoscopy, compared the clinical effect, clinical symptoms relieving time, hospitalization time, blood gas analysis, pulmonary function in each group and between two groups. Results The clinical effect in the treatment group was better than the control group（P〈0.05）, the clinical symptoms relieving time and the average hospitalization time in the treatment group were shorter than the control group （P〈0.05）, the blood gas analysis indexes （PaO2, PaO2/FiO2, SaO2） had no significant difference before treatment in two groups （P〉0.05）, and significantly improved after treatment than before treatment in two groups（P〈0.05 ）, those in the treatment group significantly increased than the control group after treatment （P〈0.05）, the pulmonary ventilation function indexes （VC, FEVt, FEV1%, V50, MVV） had no significant difference before treatment in two groups （P〉0.05）, and significantly improved in the treatment group after treatment （P〈0.05）. Conclusion The curative effect of BAL and local administration by fiberoptic bronchoscopy in the treatment of bronchiectasis with infection is safe, reliable, precise and well worth clinical application.