支气管镜肺泡灌洗在广泛耐药不动杆菌肺炎中的治疗价值及血清IL-6、PCT的变化情况

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Abstract ObjectiveTo investigate the value of bronchoalveolar lavage (BAL)in the treatment of extensively resistant Acinetobacter pneumonia and the changes of serum IL-6 and PCT.MethodsThe 50 patients with pneumonia treated in our hospital from January 2014 to June 2017 were selected and randomly divided into group A and group B according to CPIS scores,PCT values and stratified randomized grouping method,25 patients in each group.The patients in group A were treated with 1 g of Meropenem and 3 g of Piperacillin and Sulbactam,each 8 h intravenous drip was injected 1 time,the patients were treated for 2 consecutive weeks.The patients in group B were given electronic endotracheal tube lavage on the basis of antibiotic treatment of group A,daily or alternate days(depending on the amount of sputum and tolerance of the patient).The clinical pulmonary infection score,oxygenation index,serum IL-6 and PCT level of the two groups were compared before and after treatment for 1 or 2 weeks.ResultsAfter 1 week of treatment,the indicators of group A were compared with those before treatment,and the differences were not statistically significant(P＞0.05).The serum IL-6 and PCT of patients in group B were lower than before treatment,and the differences were statistically significant(P＜0.05),but CPIS score was compared with that before treatment,the difference was not statistically significant(P＞0.05).After 1 week of treatment,patients of group B with serum IL-6 and PCT were lower than those in group A,the PaO2/FiO2was significantly higher than that of group A,the differences were statistically significant(P＜0.05),while the CPIS score of patients in group B was compared with group A,the difference was not statistically significant(P＞0.05).After 2 weeks of treatment,the serum IL-6 and PCT of patients in group A were lower than before the treatment,the PaO2/FiO2was higher than before the treatment,and the differences were statistically significant(P＜0.05),but the CPIS score was compared with before treatment,the difference was not statistically significant(P＞0.05).The serum IL-6,PCT and CPIS score in group B were lower than before treatment,while PaO2/FiO2was higher than before the treatment,and the differences were statistically significant(P＜0.05).After 2 weeks of treatment,the serum IL-6,PCT and CPIS score in group B were significantly lower than those in group A,while the PaO2/FiO2was significantly higher than group A,and the differences were statistically significant(P＜0.05).ConclusionFor patients with lung infection caused by extensively drug-resistant Acinetobacter,bronchoalveolar lavage can rapidly decrease the serum levels of IL-6 and PCT,improve oxygenation and relieve the clinical symptoms.

Key words： Bronchoalveolar lavage Extensively drug-resistant Acinetobacter Pneumonia IL-6 Procalcitonin(PCT)

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	DENG Zhi-qiang
	FENG Xue-ying
	HUAN Jian

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DENG Zhi-qiang,FENG Xue-ying,HUAN Jian. The experience of bronchoalveolar lavage with bronchoscope in the treatment of pneumonia caused by extensively drug-resistant Acinetobacter and the changes of serum IL-6 and PCT[J]. 中国当代医药, 2018, 25(2): 25-28.

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