支氣管鏡下肺泡灌洗并抗生素灌注輔助治療肺癌術(shù)后肺部感染效果觀察
發(fā)布時(shí)間：2018-11-10 07:05
【摘要】：目的探討支氣管鏡下肺泡灌洗并抗生素灌注輔助治療肺癌術(shù)后肺部感染的臨床效果。方法選擇肺癌術(shù)后肺部感染患者59例,按隨機(jī)數(shù)字表法分為觀察組30例和對(duì)照組29例。兩組均予敏感抗生素以及祛痰、止咳、糾正水電解質(zhì)紊亂、機(jī)械通氣、營(yíng)養(yǎng)支持等治療。觀察組加用支氣管鏡下肺泡灌洗聯(lián)合局部灌注抗生素30 m L(含左氧氟沙星60 mg、頭孢他啶90 mg、阿米卡星60 mg、亞胺培南75 mg),每3天治療1次,共治療2次。治療第7天(治療后)評(píng)價(jià)兩組臨床療效;行痰液標(biāo)本細(xì)菌培養(yǎng),計(jì)算痰細(xì)菌培養(yǎng)轉(zhuǎn)陰率。治療前后行臨床肺部感染評(píng)分(CPIS)。檢測(cè)兩組治療前后血清高敏C反應(yīng)蛋白(hs-CRP)、TNF-α、IL-8、降鈣素原(PCT)水平及血清腎素-血管緊張素-醛固酮系統(tǒng)(RAAS)活性指標(biāo)腎素(R)、血管緊張素Ⅱ(AngⅡ)、醛固酮(ALD)水平;比較兩組治療前后氣道呼吸力學(xué)指標(biāo)氣道阻力(Raw)、氣道峰壓(PIP)及肺順應(yīng)性(Cdyn)變化。結(jié)果觀察組總有效率及痰細(xì)菌培養(yǎng)轉(zhuǎn)陰率均明顯高于對(duì)照組,治療后CPIS及血清hs-CRP、TNF-α、IL-8、PCT、R、AngⅡ、ALD水平均低于治療前對(duì)照組治療后(P均0.05)。兩組治療后Raw、PIP均低于治療前,Cydn均高于治療前(P均0.05);治療后觀察組Raw、PIP均低于對(duì)照組,Cydn高于對(duì)照組(P均0.05)。結(jié)論支氣管鏡下肺泡灌洗并抗生素灌注輔助治療肺癌術(shù)后肺部感染療效滿意,有助于減輕呼吸道癥狀、促進(jìn)病原菌清除、減輕全身炎癥反應(yīng)、抑制RAAS系統(tǒng)活性及改善呼吸道力學(xué)指標(biāo)。
[Abstract]:Objective to investigate the clinical effect of bronchoalveolar lavage combined with antibiotic infusion in the treatment of postoperative lung cancer infection. Methods 59 patients with pulmonary infection after lung cancer operation were randomly divided into observation group (n = 30) and control group (n = 29). Both groups were treated with sensitive antibiotics, expectorant, cough, water and electrolyte disturbance, mechanical ventilation and nutritional support. The observation group was treated with bronchoalveolar lavage combined with local antibiotics for 30 m L (, containing levofloxacin for 60 mg, ceftazidime 90 mg, amikacin 60 mg, imipenem, 75 mg), every 3 days, 2 times. On the 7th day after treatment, the clinical efficacy of the two groups was evaluated, and the sputum bacteria culture was carried out and the negative rate of sputum bacteria culture was calculated. Clinical pulmonary infection score (CPIS). Before and after treatment Serum levels of Gao Min C-reactive protein (hs-CRP), TNF- 偽, IL-8, procalcitonin (PCT) and serum renin-angiotensin-aldosterone system (RAAS) activity were measured before and after treatment in both groups. Angiotensin 鈪，
本文編號(hào)：2321735
[Abstract]:Objective to investigate the clinical effect of bronchoalveolar lavage combined with antibiotic infusion in the treatment of postoperative lung cancer infection. Methods 59 patients with pulmonary infection after lung cancer operation were randomly divided into observation group (n = 30) and control group (n = 29). Both groups were treated with sensitive antibiotics, expectorant, cough, water and electrolyte disturbance, mechanical ventilation and nutritional support. The observation group was treated with bronchoalveolar lavage combined with local antibiotics for 30 m L (, containing levofloxacin for 60 mg, ceftazidime 90 mg, amikacin 60 mg, imipenem, 75 mg), every 3 days, 2 times. On the 7th day after treatment, the clinical efficacy of the two groups was evaluated, and the sputum bacteria culture was carried out and the negative rate of sputum bacteria culture was calculated. Clinical pulmonary infection score (CPIS). Before and after treatment Serum levels of Gao Min C-reactive protein (hs-CRP), TNF- 偽, IL-8, procalcitonin (PCT) and serum renin-angiotensin-aldosterone system (RAAS) activity were measured before and after treatment in both groups. Angiotensin 鈪，
本文編號(hào)：2321735
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