Application of bronchoalveolar lavage and localized infusion of antibiotics in patients with refractory pulmonary infection
Objective To evaluate the effect of bronchoalveolar lavage and localized infusion of antibiotics on refractory pulmonary infection and its impact on distribution of pathogenic bacteria.Methods This study was a randomized controlled trial.A total of 100 patients with refractory pulmonary infection treated in Xi'an Chest Hospital from June 2020 to June 2023 were selected and were divided into a control group(50 cases)and an observation group(50 cases)according to the random number table method.In the control group,there were 21 males and 29 females,aged(58.23±2.33)years,with a body mass index of(22.13±2.12)kg/m2,who received conventional treatment,and the efficacy was evaluated after 9 days of continuous treatment.In the observation group,there were 24 males and 26 females,aged(60.12±3.05)years,with a body mass index of(21.53±2.31)kg/m2,who received bronchoalveolar lavage and localized injection of antibiotics on the basis of conventional treatment,once every 3 days,and the efficacy were evaluated after 3 consecutive treatments.The serum indicators,clearance of pathogenic bacteria in sputum culture,and drug resistance of the two groups were compared.x2 test and t test were used.Results After 9 days of treatment,serum levels of total oxidation state(TOS),C-reactive protein(CRP),adenosine deaminase(ADA),oxidative stress index(OSI),tumor necrosis factor α(TNF-α),interleukin-8(IL-8),procalcitonin(PCT),renin(R),and angiotensin Ⅱ(Ang Ⅱ)in both groups were decreased compared with those before treatment,and the levels of total antioxidant state(TAS)were increased compared with those before treatment(all P＜0.05);serum levels of TOS,CRP,ADA,OSI,TNF-α,IL-8,PCT,R,and Ang Ⅱ in the observation group were(13.65±1.39)μmol/L,(13.02±1.89)mg/L,(42.36±3.85)U/L,(5.54±1.06)U/L,(14.65±2.56)ng/L,(99.67±13.54)ng/L,(16.27±4.66)ng/L,(1.23±0.45)ng/L,and(23.14±6.43)ng/L,which were lower than those in the control group[(15.54±2.68)μmol/L,(25.38±2.14)mg/L,(50.28±4.11)U/L,(7.25±1.02)U/L,(26.57±5.12)ng/L,(148.39±21.28)ng/L,(22.57±4.53)ng/L,(1.98±0.65)ng/L,and(36.86±8.11)ng/L],and the TAS level was higher than that in the control group[(3.01±1.01)μmol/L vs.(2.25±0.97)μmol/L],with statistically significant differences(all P＜0.05).The total effective rate of the observation group was higher than that of the control group[92.00％(46/50)vs.76.00％(38/50)],with a statistically significant difference(x2=4.762,P=0.029).Before treatment,55 strains of pathogenic bacteria were detected in the sputum culture of the control group,including 31 strains of gram-negative bacteria(56.36％)and 24 strains of gram-positive bacteria(43.64％);53 strains of pathogenic bacteria were detected in the sputum culture of the observation group,including 34 strains of gram-negative bacteria(64.15％)and 19 strains of gram-positive bacteria(35.85％).Sputum culture after 9 days of treatment showed that the clearance rate of pathogenic bacteria in the observation group was higher than that in the control group[76.00％(38/50)vs.54.00％(27/50)],with a statistically significant difference(x2=5.319,P=0.021).Conclusions Bronchoalveolar lavage and localized infusion of antibiotics can significantly improve the biochemical indexes in patients with refractory pulmonary infection,increase the clearance rate of pathogenic bacteria,and improve the patients'prognosis.This provides a new treatment option for patients with severe lung infection.
Bronchoalveolar lavageAntibioticsPulmonary infectionPathogen distribution
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维普
