支气管镜在重症肺部感染患者中的临床应用

摘要

目的 探讨支气管镜在重症肺部感染治疗中的应用价值.方法 回顾性分析140例重症肺部感染患者,包括胸腹部手术后肺部感染,肺部感染合并阻塞性肺不张,慢性阻塞性肺疾病急性加重期以及其它合并肺部感染的危重症患者,经过常规抗感染治疗疗效不佳,同时给予支气管镜治疗,并做分泌物培养及药物敏感试验,观察临床症状、血氧饱和度、肺部体征及胸部CT的改变.结果 140例患者总有效率96％.灌洗液培养116例阳性,阳性率83％,未发生严重并发症.结论 对于严重肺部感染患者应当尽早在监护条件下行支气管镜治疗,包括吸痰及支气管肺泡灌洗,有利于清除气道内的分泌物,改善肺通气功能,明确病原菌及合理选用抗生素,缩短住院时间,加快病情的好转.%Objective To discuss the value of bronchoscope to treat grave pulmonary infection. Methods 140 grave pulmonary infection patients were retrospectively analyzed. The patients were include the pulmonary infection after the operation, the atelectasis. the AE-COPD and so on. They accepted bronchoscope at the same time, and the secretion through the bronchoscope were cultured. The symptom, the oxygen saturation of blood, the sign of lung and the CT of the lung were observed. Results The effective rates was 96%. The positive rate of lavage's germiculture was 83%. There were not serious complications. Conclusion The bronchoscope lavage was very importable to grave pulmonary infection patients. It's good to clear the secretion.,reform the lung ventilate, use antibacterial logical, reduce the time in hospital and get well quickly.