【摘要】：目的探討中心型肺癌并發(fā)阻塞性肺炎患者病原菌分布及耐藥性,并對藥物治療后療效進行觀察,為臨床診斷治療提供決策依據(jù)。方法選取2012年1月-2016年3月醫(yī)院住院治療的89例中心型肺癌并發(fā)阻塞性肺炎患者,采集患者痰液標本進行培養(yǎng)鑒定,觀察病原菌分布及藥敏試驗結(jié)果;按治療方式將患者分為對照組36例與觀察組53例,對照組給予單純支氣管灌注治療,觀察組在對照組治療基礎(chǔ)上同時采用敏感抗菌藥物進行灌注治療,比較兩組患者的臨床療效。結(jié)果痰培養(yǎng)共分離病原菌211株,其中革蘭陰性菌124株占58.77%;革蘭陽性菌51株占24.17%;真菌36株占17.06%;排前5位的病原菌依次為肺炎克雷伯菌、銅綠假單胞菌、白假絲酵母、金黃色葡萄球菌及凝固酶陰性葡萄球菌,分別占22.22%、19.91%、12.32%、11.37%、9.95%;肺炎克雷伯菌對亞胺培南及美羅培南最敏感,金黃色葡萄球菌對萬古霉素及呋喃妥因最敏感,敏感率均達100.00%;而白假絲酵母對兩性霉素B最敏感,敏感率為100.00%;觀察組治療總有效率為94.34%,顯著高于對照組的83.33%,兩組比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論支氣管動脈化療藥物灌注術(shù)治療過程中同時灌注抗腫瘤藥物與敏感抗菌藥物,是治療中心型肺癌合并阻塞性肺炎的理想治療方法。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in patients with central lung cancer complicated with obstructive pneumonia, and to observe the curative effect after drug treatment, so as to provide decision-making basis for clinical diagnosis and treatment. Methods from January 2012 to March 2016, 89 patients with central lung cancer complicated with obstructive pneumonia were selected. Sputum samples were collected and identified, and the distribution of pathogenic bacteria and the results of drug sensitivity test were observed. According to the treatment method, the patients were divided into control group (n = 36) and observation group (n = 53). The control group was treated with bronchial perfusion alone, and the observation group was treated with sensitive antibiotics on the basis of the treatment in the control group. The clinical efficacy of the two groups was compared. Results 211 strains of pathogenic bacteria were isolated from sputum culture, including 124 strains of Gram-negative bacteria (58.77%), 51 strains of Gram-positive bacteria (24.17%) and 36 strains of fungi (17.06%). The top five pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa, Pseudomonas albicans, Staphylococcus aureus and coagulase negative Staphylococcus, accounting for 22.22%, 19.91%, 12.32%, 11.37% and 9.95%, respectively. Klebsiella pneumoniae was the most sensitive to imipenem and meropenem, Staphylococcus aureus was the most sensitive to vancomycin and furantoin, while candida albicans was the most sensitive to amphotericin B (100.00%). The total effective rate of the observation group was 94.34%, which was significantly higher than that of the control group (83.33%). There was significant difference between the two groups (P 0.05). Conclusion simultaneous infusion of antitumor drugs and sensitive antibiotics in the treatment of central lung cancer complicated with obstructive pneumonia is an ideal method for the treatment of central lung cancer complicated with obstructive pneumonia.
【作者單位】： 武漢市醫(yī)療救治中心呼吸病介入診療科;武漢市醫(yī)療救治中心麻醉科;
【基金】：武漢市衛(wèi)生與計劃生育委員會科研基金資助項目(WG16C10)
【分類號】：R563.1;R734.2
，

本文編號：2483646