支气管镜下肺泡灌洗并抗生素灌注辅助治疗肺癌术后肺部感染效果观察
发布时间：2018-11-10 07:05
【摘要】：目的探讨支气管镜下肺泡灌洗并抗生素灌注辅助治疗肺癌术后肺部感染的临床效果。方法选择肺癌术后肺部感染患者59例,按随机数字表法分为观察组30例和对照组29例。两组均予敏感抗生素以及祛痰、止咳、纠正水电解质紊乱、机械通气、营养支持等治疗。观察组加用支气管镜下肺泡灌洗联合局部灌注抗生素30 m L(含左氧氟沙星60 mg、头孢他啶90 mg、阿米卡星60 mg、亚胺培南75 mg),每3天治疗1次,共治疗2次。治疗第7天(治疗后)评价两组临床疗效;行痰液标本细菌培养,计算痰细菌培养转阴率。治疗前后行临床肺部感染评分(CPIS)。检测两组治疗前后血清高敏C反应蛋白(hs-CRP)、TNF-α、IL-8、降钙素原(PCT)水平及血清肾素-血管紧张素-醛固酮系统(RAAS)活性指标肾素(R)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平;比较两组治疗前后气道呼吸力学指标气道阻力(Raw)、气道峰压(PIP)及肺顺应性(Cdyn)变化。结果观察组总有效率及痰细菌培养转阴率均明显高于对照组,治疗后CPIS及血清hs-CRP、TNF-α、IL-8、PCT、R、AngⅡ、ALD水平均低于治疗前对照组治疗后(P均0.05)。两组治疗后Raw、PIP均低于治疗前,Cydn均高于治疗前(P均0.05);治疗后观察组Raw、PIP均低于对照组,Cydn高于对照组(P均0.05)。结论支气管镜下肺泡灌洗并抗生素灌注辅助治疗肺癌术后肺部感染疗效满意,有助于减轻呼吸道症状、促进病原菌清除、减轻全身炎症反应、抑制RAAS系统活性及改善呼吸道力学指标。
[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- 伪, IL-8, procalcitonin (PCT) and serum renin-angiotensin-aldosterone system (RAAS) activity were measured before and after treatment in both groups. Angiotensin 鈪，
本文编号：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- 伪, IL-8, procalcitonin (PCT) and serum renin-angiotensin-aldosterone system (RAAS) activity were measured before and after treatment in both groups. Angiotensin 鈪，
本文编号：2321735
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