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目的观察经纤维支气管镜肺泡灌洗联合局部灌注阿米卡星、甲硝唑治疗醉酒致吸入性肺炎的临床疗效。方法将36例醉酒致吸入性肺炎患者按照随机数字表法随机分为试验组和对照组,每组18例。对照组给予常规抗感染、化痰、吸氧、普通吸痰、维持内环境稳定等内科治疗。试验组在对照组的基础上进行经纤维支气管镜生理盐水肺泡灌洗并局部灌注药物(阿米卡星0.4g+甲硝唑0.2g+生理盐水20ml),比较2组临床疗效及患者住院时间、抗生素使用时间、咳嗽咯痰缓解时间、肺部啰音消失时间,并观察试验组患者灌洗术后不良反应发生情况。结果试验组总有效率为94.4%高于对照组的77.8%,住院时间、抗生素使用时间、咳嗽咯痰缓解时间、肺部啰音消失时间均短于对照组,差异均有统计学意义(P<0.05)。试验组患者灌洗术后自觉咽部不适1例(5.6%),操作过程中有一过性低氧血症、心率加快1例(5.6%),无严重并发症出现。结论经纤维支气管镜肺泡灌洗并局部灌注药物治疗醉酒致吸入性肺炎临床效果显著,能快速改善症状,缩短住院时间,疗效确切。
Objective To observe the clinical efficacy of bronchoscopical bronchoalveolar lavage combined with local infusion of amikacin and metronidazole in the treatment of alcohol-induced aspiration pneumonia. Methods Thirty-six patients with aspiration pneumonia were randomly divided into experimental group and control group according to random number table method, with 18 cases in each group. The control group was given routine anti-infection, phlegm, oxygen, ordinary suction, to maintain the stability of the internal environment and other medical treatment. In the test group the control group based on bronchofibroscope saline lavage and local drug infusion (amikacin 0.4g + 0.2g + metronidazole saline 20ml), and the two groups were compared the clinical efficacy of hospital stay, antibiotics Time of use, cough and expectoration to relieve time, pulmonary rales disappear time, and observe the experimental group of patients after lavage adverse reactions. Results The total effective rate of the experimental group was 94.4%, which was significantly higher than that of the control group (77.8%). The duration of hospitalization, the duration of antibiotics, the time to relieve cough and expectoration, and the disappearance of pulmonary rales were all shorter than those in the control group (P <0.05). One patient (5.6%) experienced hypopharyngeal discomfort after lavage in experimental group, one had transient hypoxemia during operation, one case (5.6%) had accelerated heart rate and no serious complications occurred. Conclusion Bronchoscopical bronchoalveolar lavage and local perfusion drug treatment of aspiration pneumonia caused by aspiration significant clinical effect, can quickly improve the symptoms and shorten the length of stay, the exact effect.