Observation on the clinical effect of inhaled acetylcysteine fiberoptic bronchoalveolar lavage regimen combined with cefoperazone/sulbactam in the treatment of severe pneumonia caused by Gram-negative bacteria
Objective To explore the effect of fiberoptic bronchoscopic alveolar lavage regimen with inhaled N-acetylcysteine(NAC)combined with cefoperazone/sulbactam in the treatment of Gram-negative bacteria caused severe pneumonia and its influence on blood gas indicators,oxygenation index and prognosis.Methods One hundred and sixty patients with Gram-negative bacteria-caused severe pneumonia were selected.The patients were divided into a control group and a lavage group according to different treatment methods,80 in each group.The control group was treated with conventional symptomatic treatment+cefoperazone/sulbactam).The lavage group was treated with NAC fiberoptic bronchoscopic alveolar lavage regimen on the basis of the control group.The therapeutic effect was compared between the two groups.Blood gas indicators such as arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),blood oxygen saturation(SaO2)and oxygenation index(PaO2/FiO2)and serum inflammatory markers such as monocyte count(MONO),serum amyloid A(SAA)and neutrophil count(ANC)before and after treatment were compared between the two groups.The prognosis status such as intensive care time,ventilator use time,multiple organ failure rate and mortality was recorded.Results The effective rate of treatment in the lavage group was significantly higher than that in the control group(P＜0.05).After 1 week of treatment,the blood gas indicators of PaO2,SaO2 and PaO2/FiO2 in both groups were significantly increased(P＜0.05)while the PaCO2was significantly decreased(P＜0.05),and the changes of the above indicators were significantly higher in the lavage group than those in the control group(P＜0.05).The levels of MONO,SAA and ANC in the two groups were significantly reduced after 1 week of treatment(P＜0.05),and the levels in the lavage group were significantly lower than those in the control group(P＜0.05).The intensive care time,ventilator use time and multiple organ failure rate in the lavage group were significantly shorter or lower than those in the control group(P＜0.05).There was no significant difference in the incidence rates of adverse events and in the 28d mortality between the two groups(P＞0.05).Conclusions NAC fiberoptic bronchoscopic alveolar lavage regimen combined with cefoperazone/sulbactam have a significant efficacy in the treatment of Gram-negative bacteria caused severe pneumonia.It can effectively increase oxygenation level,reduce the inflammatory response,and improve the prognosis of the patients.It is worth recommending.
Severe pneumoniaFiberoptic bronchoscopic alveolar lavageNACBlood gas indicatorsEfficacy
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维普
