姚菲菲

[摘要] 目的 研究分析纤维支气管镜肺泡灌洗治疗支气管扩张合并感染的临床效果。 方法 整群选取2013年9月—2015年9月该院收治的支气管扩张合并感染患者74例，随机分为两组，各37例。对照组采用常规治疗，观察组采用纤维支气管镜肺泡灌洗治疗，对比两组临床症状缓解时间、治疗前后血清TNF-α和hs-CRP指标情况。 结果 观察组咳嗽咳痰、发热和肺部湿罗音等症状缓解时间明显短于对照组，差异有统计学意义（P<0.05）；观察组治疗后血清TNF-α和hs-CRP水平明显低于对照组，差异有统计学意义（P<0.05）。 结论 纤维支气管镜肺泡灌洗治疗支气管扩张合并感染效果显著，能够明显缓解患者临床症状，降低血清炎症因子水平，值得推广。

[Abstract] Objective To research and analyze the clinical effect of bronchoalveolar lavage by bronchofibroscopy in treatment of bronchiectasia combined with infection. Methods 74 cases of patients with bronchiectasia combined with infection treated in our hospital from September 2013 to September 2015 were selected and randomly divided into two groups with 37 cases in each， the control group were treated with conventional method， the observation group were treated with bronchoalveolar lavage by bronchofibroscopy， the clinical symptom relief time and the index such as serum TNF-α and hs-CRP before and after treatment of the two groups were compared. Results The relief time of symptoms such as cough， expectoration， fever and moist vales of lung in the observation group was obviously shorter than that in the control group， the difference was statistically significant （P<0.05）； the serum TNF-α and hs-CRP levels after treatment in the observation group were obviously lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion Bronchoalveolar lavage by bronchofibroscopy in treatment of bronchiectasia combined with infection has an obvious effect， and it can obviously relieve the patients clinical symptoms and decrease serum inflammatory cytokines， which is worth promoting.

[Key 支气管扩张是一种发病率较高的疾病，患者主要临床症状为咳嗽、咳血等，并且大部分患者会出现感染症状[1]。对于此类患者过去通常会给予抗生素治疗，但是抗生素达到病灶部位的浓度不足，并且长时间给予抗生素治疗可显著增加不良反应发生率。而目前随着医疗技术的提高，可给予患者纤维支气管镜肺泡灌洗治疗，其能够显著清除呼吸道分泌物，抑制感染[2-3]。为进一步探究纤维支气管镜肺泡灌洗对于支气管扩张合并感染疗效，在该研究中给予支气管扩张合并感染患者此方法，现报道如下。

1 资料与方法

1.1 一般资料

整群选取2013年9月—2015年9月该院收治的支气管扩张合并感染患者74例，随机分为两组，各37例。对照组男20例，女17例；年龄62～84岁，平均年龄为（72.15±7.41）岁；病程为5.2～22.8年，平均病程为（13.80±2.75）年。观察组男21例，女16例；年龄60～85岁，平均年龄为（72.42±7.28）岁；病程为5.4～22.9年，平均病程为（13.45±2.80）年。两组一般资料差异无统计学意义（P>0.05）。

1.2 方法

对照给予常规抗感染、化痰等治疗，观察组在此基础上给予纤支镜肺泡灌洗治疗，在治疗前8 h禁食，在局麻后经鼻腔置入纤支镜，洗净支气管内分泌物，送检细菌培养。纤……