标题：支气管镜灌洗联合局部注药治疗难治性肺部多重耐药菌感染62例疗效观察

      作者：刘玲，蒋飞，李逢斌    （重庆市九龙坡区第二人民医院呼吸内科，重庆 400052）

      卷次： 2016年27卷24期

      【摘要】 目的 观察支气管镜肺泡灌洗联合局部注入抗生素药物治疗难治性肺部多重耐药菌感染患者的临床疗效。方法 选取我院呼吸内科2012年1月至2016年1月收治的难治性肺部多重耐药菌感染患者62例，按照随机数表法分为对照组和观察组,每组各 31例，其中对照组患者均给予常规静脉抗感染、祛痰及机械辅助排痰等治疗，观察组患者在常规治疗基础上采用电子支气管镜进行肺泡灌洗并在病变部位注入敏感抗生素进行治疗。比较两组患者的临床有效率、发热时间、抗生素使用时间、血常规恢复正常时间和住院时间。结果 观察组患者治疗后的临床有效率为93.55%，明显高于对照组的74.19%，差异有统计学意义(P<0.05)；治疗后观察组患者的发热时间、抗生素使用时间、血常规恢复正常时间、住院时间明显短于对照组，差异均有统计学意义(P<0.05)。结论 支气管镜肺泡灌洗联合局部注药治疗难治性肺部多重耐药菌感染患者临床效果好，值得临床应用推广。
      【关键词】 电子支气管镜；局部注药；难治性肺部感染；多重耐药菌
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2016）24—4082—03

Efficacy of bronchoalveolar lavage combined with local injection in 62 patients of refractory pulmonary infectionwith multiple drug resistant bacteria.
LIU Ling, JIANG Fei, LI Feng-bin. Department of Respiratory Medicine, theSecond People's Hospital of JiuLongpo District of Chongqing, Chongqing 400052, CHINA
【Abstract】 Objective To observe the clinical effect of bronchoalveolar lavage combined with local injectionof antibiotics in the treatment of patients of refractory pulmonary infection with multiple drug resistant bacteria.Methods A total of 62 patients with refractory pulmonary infection with multiple drug resistant bacteria, who admittedto Department of Respiratory Medicine of our hospital from January 2012 to January 2016, were randomly divided intothe control group and the observation group, with 31 patients in each group. Patients in the control group were given con-ventional intravenous anti-infective, expectorant and mechanical-assisted expectoration therapy; on the basis of conven-tional therapy, the patients in the observation group were treated with electronic bronchoscopy for bronchoalveolar la-vage and sensitive antibiotics were injected into the lesion. The clinical efficiency, the duration of fever, antibiotic usetime, blood recovery time and hospitalization time of the two groups were compared. Results The clinical effectiverate of the observation group (93.55%) after treatment was significantly higher than that of the control group (74.19%),P<0.05. After treatment, the duration of fever, antibiotic use time, blood recovery time and hospitalization time of the ob-servation group were significantly shorter than those of the control group (P<0.05). Conclusion Bronchoalveolar la-vage combined with local injection has good clinical efficacy in the treatment of refractory pulmonary infection withmulti drug resistant bacteria. It is worthy of clinical application.
      【Key words】 Electron bronchoscopy; Local injection; Refractory pulmonary infection; Multi drug resistant bacteria·临床经验·doi:10.3969/j.issn.1003-6350.2016.24.041