中心型肺癌并发阻塞性肺炎的病原学特点及药物介入治疗的疗效

发布时间：2019-05-23 05:34

【摘要】：目的探讨中心型肺癌并发阻塞性肺炎患者病原菌分布及耐药性,并对药物治疗后疗效进行观察,为临床诊断治疗提供决策依据。方法选取2012年1月-2016年3月医院住院治疗的89例中心型肺癌并发阻塞性肺炎患者,采集患者痰液标本进行培养鉴定,观察病原菌分布及药敏试验结果;按治疗方式将患者分为对照组36例与观察组53例,对照组给予单纯支气管灌注治疗,观察组在对照组治疗基础上同时采用敏感抗菌药物进行灌注治疗,比较两组患者的临床疗效。结果痰培养共分离病原菌211株,其中革兰阴性菌124株占58.77%;革兰阳性菌51株占24.17%;真菌36株占17.06%;排前5位的病原菌依次为肺炎克雷伯菌、铜绿假单胞菌、白假丝酵母、金黄色葡萄球菌及凝固酶阴性葡萄球菌,分别占22.22%、19.91%、12.32%、11.37%、9.95%;肺炎克雷伯菌对亚胺培南及美罗培南最敏感,金黄色葡萄球菌对万古霉素及呋喃妥因最敏感,敏感率均达100.00%;而白假丝酵母对两性霉素B最敏感,敏感率为100.00%;观察组治疗总有效率为94.34%,显著高于对照组的83.33%,两组比较差异有统计学意义(P0.05)。结论支气管动脉化疗药物灌注术治疗过程中同时灌注抗肿瘤药物与敏感抗菌药物,是治疗中心型肺癌合并阻塞性肺炎的理想治疗方法。
[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.
【作者单位】： 武汉市医疗救治中心呼吸病介入诊疗科;武汉市医疗救治中心麻醉科;
【基金】：武汉市卫生与计划生育委员会科研基金资助项目(WG16C10)
【分类号】：R563.1;R734.2
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本文编号：2483646