蒋晨琳 彭伟 怀佳萍

[摘要] 目的 分析床旁纤维支气管镜治疗肺部肿瘤术后肺部感染患者的临床疗效。 方法 选取2019年1月至2020年6月在我院心胸外科行肺部肿瘤手术后出现肺部感染患者60例，分为两组，观察组30例，对照组30例，其中对照组予以常规治疗，观察组在对照组的基础上加用床旁纤维支气管镜治疗，比较两组治疗效果、发热持续时间、抗生素使用时间、白细胞计数、超敏C-反应蛋白水平、住院时间。 结果 观察组的总有效率为83.33%，高于对照组的50.00%，差异有统计学意义（P<0.05）;相较于对照组，观察组患者发热持续时间、抗生素使用时间缩短，白细胞计数、超敏C-反应蛋白水平有明显改善，住院时间缩短，差异有统计学意义（P<0.05）。 结论 对肺部肿瘤术后肺部感染患者早期应用床旁纤维支气管镜治疗有良好的临床治疗效果。

[关键词] 肺部肿瘤;床旁纤维支气管镜;吸痰;肺泡灌洗;肺部感染

[中图分类号] R563          [文献标识码] B          [文章编号] 1673-9701（2021）33-0113-04

[Abstract] Objective To analyze the clinical efficacy of bedside fiberoptic bronchoscopy in the treatment of patients with pulmonary infection after pulmonary tumor surgery. Methods A total of 60 patients with pulmonary infection after pulmonary tumor surgery in the Department of Cardiothoracic Surgery of our hospital from January 2019 to June 2020 were divided into the observation group （n=30） and the control group （n=30）. The control group was given routine treatment. The observation group was given bedside fiberoptic bronchoscopy based on the treatment of the control group. The therapeutic effect， duration of fever， duration of antibiotic use， white blood cell count， high-sensitivity C-reactive protein level， and hospital stay were compared between the two groups. Results The total effective rate of the observation group was 83.33%， which was higher than that of the control group（50.00%）， and the difference was statistically significant（P<0.05）. Compared with the control group， the duration of fever and the duration of antibiotic use in the observation group were shortened， the white blood cell count and high-sensitivity C-reactive protein levels were significantly improved， and the length of hospital stay was shortened，the difference was statistically significant（P<0.05）. Conclusion Early application of bedside fiberoptic bronchoscopy in the treatment of pulmonary infection after pulmonary tumor surgery has a good clinical effect.

[Key words] Lung neoplasm; Bedside fiberoptic bronchoscopy; Sputum suction; Alveolar lavage; Lung infection

肺部感染是胸部腫瘤术后常见的并发症，使患者术后恢复受到影响，增加患者住院费用及住院时间，易造成急性呼吸衰竭，严重者危及患者生命。随着治疗方式的不断进步，纤维支气管镜在肺部感染治疗中得到广泛应用。纤维支气管镜可以清晰观察各肺叶情况，清除气道分泌物，通过肺泡灌洗可对肺内深部分泌物进行冲洗，减轻炎症反应[1]。可选择性地留取痰液进行细菌学培养，从而选择高效敏感抗生素，有效控制感染，对挽救患者生命起到决定性作用。本研究通过对我院肺部肿瘤术后肺部感染患者进行早期纤维支气管镜治疗，并探讨其临床应用价值，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年1月至2020年6月在我院接受胸外科手术，并于术后评估存在肺部感染的患者。纳入标准：①体温超过38℃持续2 d以上，痰液量多者;②双肺或单侧肺部听诊存在湿性啰音者;③术后胸部X线检查发现肺部有感染的特点者;④血常规检查提示白细胞及C-反应蛋白持续增高者[2]。……