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目的探讨纤维支气管镜肺灌洗术治疗重度颅脑损伤患者肺部感染的临床疗效,为临床降低肺部感染的发生率提供参考。方法选取2011年9月-2014年11月医院接诊的66例重度颅脑损伤发生肺部感染患者,按照入院时间先后顺序将其分为两组,各33例,对照组给予常规治疗,观察组在常规治疗的基础上给予纤维支气管镜肺灌洗术治疗,比较两组患者的治疗情况、各项治疗指标、疗效以及不良反应。结果观察组机械通气时间、发热时间、肺部啰音消失时间、抗菌药物使用时间均短于对照组,观察组感染控制时间、二氧化碳分压优于对照组;观察组细菌培养阳性率、血氧饱和度均高于对照组;观察组的病死率为0.09%、总有效率为90.90%,对照组分别为30.30%、54.45%,两组比较差异均有统计学意义(P<0.05);两组不良反应比较差异无统计学意义。结论纤维支气管镜肺灌洗术治疗重度颅脑损伤合并肺部感染的临床疗效良好、安全性较高,值得临床推广应用。
Objective To investigate the clinical effects of bronchofibroscopy lavage in the treatment of pulmonary infection in patients with severe craniocerebral injury and provide references for reducing the incidence of pulmonary infection clinically. Methods Sixty-six patients with severe traumatic brain injury who admitted to the hospital from September 2011 to November 2014 were selected and divided into two groups according to the sequence of admission time: 33 cases in each group, and the control group was given routine treatment. The patients were treated by bronchofiberscopy and lung lavage on the basis of routine treatment. The treatment, comparison of the therapeutic indexes, curative effects and adverse reactions of the two groups were compared. Results The duration of mechanical ventilation, fever time, disappearance of pulmonary rales and antibacterial drug use time in the observation group were shorter than those in the control group. The infection control time and the partial pressure of carbon dioxide in the observation group were better than those in the control group. The positive rates of bacterial culture, The mortality of observation group was 0.09%, the total effective rate was 90.90%, while the control group was 30.30% and 54.45%, respectively. There was significant difference between the two groups (P <0.05) There was no significant difference in adverse reactions between groups. Conclusion The clinical effect of fibrobronchial lung lavage for the treatment of severe craniocerebral injury with pulmonary infection is good and safe, which is worthy of clinical application.