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目的探讨经纤维支气管镜对矽肺患者肺部局部感染病灶(参照肺部CT影像定位)行支气管肺泡灌洗加全身抗感染治疗矽肺合并重症肺部感染患者的疗效。方法将广西壮族自治区职业病防治研究院2009—2011年收治的32例矽肺合并重症肺部感染患者随机分为2组,观察组(16例)给予纤维支气管镜行支气管肺泡灌洗及局部用药,每周期2次,并全身抗感染及支持对症治疗,根据药敏结果选用抗生素;对照组(16例)单用抗生素全身抗感染及对症支持治疗。结果观察组16例治疗后的血气分析指标均较治疗前改善(均P<0.01),其显效率为75.0%,总有效率为93.8%;对照组16例,显效率为37.5%,总有效率为75.0%,治疗组显效率明显高于对照组(χ2=4.571,P<0.05)。结论经支气管镜行支气管肺泡灌洗治疗,能及时清除气道分泌物,改善肺通气功能,可明显提高矽肺重症肺部感染患者的治愈率,是一种治疗重症肺部感染行之有效的治疗方法,值得临床进一步研究推广。
Objective To investigate the curative effect of bronchofibroscopy on patients with silicosis complicated with severe pulmonary infection by bronchial alveolar lavage combined with systemic anti-infection in patients with local lung infection in silicosis. Methods 32 patients with severe silicosis and severe pulmonary infection in Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Treatment from 2009 to 2011 were randomly divided into two groups. The observation group (16 cases) received bronchoalveolar lavage and topical application of bronchoscopy. Cycle 2 times, systemic anti-infective and symptomatic treatment were supported. Antibiotics were selected according to drug susceptibility results. The control group (n = 16) was treated with systemic antibiotics alone and symptomatic supportive treatment. Results In the observation group, the blood gas analysis indexes of the 16 patients after treatment were both improved (all P <0.01), the effective rate was 75.0% and the total effective rate was 93.8%. In the control group, the effective rate was 37.5% The efficiency was 75.0%. The effective rate of the treatment group was significantly higher than that of the control group (χ2 = 4.571, P <0.05). Conclusion Bronchial bronchoalveolar lavage (BALF) can relieve airway secretions and improve pulmonary ventilation in time, which can significantly improve the cure rate of patients with severe pulmonary infection of silicosis. It is an effective treatment for severe pulmonary infection Method, it is worth further study to promote clinical.