支气管肺泡灌洗并局部使用阿米卡星治疗支气管扩张合并慢性阻塞性肺疾病的临床观察
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李承红

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R563

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Clinical observation on bronchoalveolar lavage and topical use of amikacin for treatment of bronchiectasis complicated with chronic obstructive pulmonary disease
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    摘要:

    目的探讨支气管肺泡灌洗并局部使用阿米卡星治疗支气管扩张合并慢性阻塞性肺疾病(COPD)患者的临床疗效。方法选取2016年1月1日—12月31日某院就诊的支气管扩张伴COPD患者为研究对象。随机将患者分为试验组与对照组。两组均给予常规治疗;对照组采用0.9%氯化钠注射液行支气管肺泡灌洗;试验组在常规治疗基础上局部使用阿米卡星溶液;比较两组患者治疗有效率、实验室检查指标及不良反应发生率。结果研究最终纳入患者47例,其中试验组24例,对照组23例。治疗后试验组总有效率(95.83%)高于对照组(69.57%),差异有统计学意义(P<0.05)。治疗后两组患者肺功能(VC、FEV1、FEV1/FVC)、外周血白细胞(WBC)、中性粒细胞百分比(N%)、超敏C反应蛋白(hsCRP)、降钙素原(PCT)水平较治疗前改善,差异具有统计学意义(P<0.05)。治疗后试验组肺功能改善优于对照组,WBC、N%、hsCRP及PCT低于对照组,差异均具有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(χ2=0.090,P=0.956)。结论支气管扩张合并COPD患者经支气管肺泡灌洗并局部使用阿米卡星灌洗治疗,疗效优于生理盐水灌洗,且不良反应发生率未增加,并可缩短住院时间,值得临床推广应用。

    Abstract:

    amikacin for treatment of patients with bronchiectasis and chronic obstructive pulmonary disease(COPD).MethodsPatients with bronchiectasis and COPD in a hospital from January 1, 2016 to December 31, 2016 were selected. They were randomly divided into trial group and control group. Two groups both received conventional treatment, control group was treated with 0.9% sodium chloride for bronchoalveolar lavage; trial group were given topical use of amikacin solution on the basis of conventional treatment. Efficacy of treatment, laboratory test results, and incidences of adverse reactions were compared between two groups of patients.ResultsA total of 47 patients were included in the study, 24 were in trial group and 23 in control group. After treatment, the total efficacy rate of trial group was significantly higher than that of control group (95.83% vs 69.57%, P<0.05). Pulmonary function (VC, FEV1, FEV1/FVC), peripheral white blood cell count (WBC), neutrophil percentage (N%), highsensitivity Creactive protein (hsCRP), and procalcitonin (PCT) levels in two groups of patients significantly improved after treatment compared with those before treatment, differences were all statistically significant (P<0.05). After treatment, improvement of pulmonary function in trial group was better than that of control group, WBC count, N%, hsCRP, and PCT were lower than control group, differences were all statistically significant (P<0.05); there was no significant difference in the incidence of adverse reactions between two groups(χ2=0.090,P=0.956).ConclusionTherapeutic efficacy of BAL and topical amikacin in the treatment of patients with bronchiectasis and COPD is superior to 0.9% sodium chloride lavage, it does not increase the incidence of adverse reaction, can shorten length of hospital stay, and is worthy of clinical application.

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王小江,李承红.支气管肺泡灌洗并局部使用阿米卡星治疗支气管扩张合并慢性阻塞性肺疾病的临床观察[J]. 中国感染控制杂志,2018,17(5):395-400. DOI:10.3969/j. issn.1671-9638.2018.05.006.
WANG Xiaojiang, LI Chenghong. Clinical observation on bronchoalveolar lavage and topical use of amikacin for treatment of bronchiectasis complicated with chronic obstructive pulmonary disease[J]. Chin J Infect Control, 2018,17(5):395-400. DOI:10.3969/j. issn.1671-9638.2018.05.006.

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  • 收稿日期:2017-06-15
  • 最后修改日期:2017-08-09
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  • 在线发布日期: 2018-05-28
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