目的 分析基于微信平台步行运动训练对慢性充血性心力衰竭(CHF)患者心脏康复水平的影响。方法 本次研究对象来源于梅州市中医医院一内科2020年11月—2021年12月住院的90例CHF患者,根据随机数字表法分组(每组n=45),对比组给予常规药物治疗,观察组在对比组基础上给予基于微信平台步行运动训练治疗,对比两组临床疗效、心脏功能指标、血清NT-proBNP、D-D、6分钟步行距离、日常生活能力评分、明尼苏达心力衰竭生活质量调查表(MLHFQ)评分。结果 观察组临床总有效率(95.56%)高于对比组(66.67%),观察组治疗后左心室舒张末期内径、左心室收缩末期内径均低于对比组,观察组治疗后左室射血分数高于对比组,观察组治疗后血清NT-proBNP、D-D均低于对比组,观察组治疗后6分钟步行距离、日常生活能力评分均高于对比组,观察组治疗后MLHFQ评分低于对比组,P＜0.05(差异均具有统计学意义)。结论 基于微信平台步行运动训练可有效改善CHF患者心功能,抑制NT-proBNP、D-D高表达,提高日常生活能力、生存质量。

Objective To analyze the effect of walking training through Wechat on cardiac rehabilitation of chronic congestive heart failure (CHF) patients. Methods A total of 90 patients with CHF hospitalized in the First Internal Medicine Department of Meizhou Traditional Chinese Medicine Hospital from November 2020 to December 2021 were enrolled in this study. They were divided into two groups according to the random number table method (45 patients in each group).The control group was given routine drug treatment,and the observation group was given walking training through Wechat on the basis of control group. The clinical efficacy,cardiac function indexes,serum NT-proBNP,D-D levels,6-minute walking distance,ability of daily life (ADL) score and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between two groups. Results The total clinical effective rate of the observation group (95.56%) was higher than that of the control group (66.67%),the LVEDd and LVESd of the observation group were lower than those of the control group after treatment,the LVEF of the observation group was higher than that of the control group after treatment,the serum NT-proBNP and D-D levels of the observation group were lower than those of the control group after treatment,the 6-minute walking distance and ADL score of the observation group were higher than those of the control group after treatment,and the MLHFQ score of the observation group was lower than that of the control group after treatment,P<0.05 (the difference was statistically significant).Conclusions Walking training by Wechat could effectively improve the cardiac function of CHF patients,inhibit the high expression of NT proBNP and D-D,and improve the ability of daily living and quality of life.

目的 探究质控预警系统在重症患儿连续性血液净化治疗的应用效果。方法 随机选取于2020年1月—2021年12月在我院进行连续性血液净化治疗的共80例重症患儿作为本次研究对象,将80例患儿随机分成研究组和对照组,对照组进行常规护理,研究组则在常规护理的基础上行预警系统质量控制,对比2组患儿连续性血液净化治疗时长及报警频次、2组患儿在不同治疗时间段内滤器凝血发生率、2组非计划下机发生情况及2组患儿家属的护理满意度。结果 研究组平均报警频次为(8.60±3.35),低于对照组(16.52±7.41)的报警频次。而研究组的治疗时长(32.54±6.73 h)较对照组(21.38±5.61 h)延长,研究组患儿在进行连续性血液净化治疗的过程中,在8小时至24小时之间及大于24小时滤器的凝血发生率低于对照组,研究组和对照组护理满意度分别为92.50%和75.00%,对比差异显著。结论 在对重症患儿进行连续性血液净化治疗过程中应用质控预警系统具有较高的临床使用价值,不仅可以有效降低报警频次及滤器凝血发生率,而且对延长治疗时间有显著的促进作用,值得在今后的治疗过程中大力推广。

Objective To explore the application effect of quality control early warning system in continuous blood purification treatment of critically ill children.Methods A total of 80 critically ill children who underwent continuous blood purification treatment in our hospital from January 2020 to December 2021 were randomly selected as the research object, and were randomly divided into observation group and control group.The control group received routine nursing,and the observation group received early warning system quality control on the basis of routine nursing.The duration and alarm frequency of continuous blood purification treatment,the incidence of filter coagulation in different treatment periods,the occurrence of unplanned quitting and nursing satisfaction of the two groups were compared.Results The average alarm frequency of the observation group was (8.60±3.35),which was significantly lower than that of the control group (16.52±7.41).However,the treatment duration of the observation group (32.54±6.73 h) was significantly longer than that of the control group (21.38±5.61 h).During continuous blood purification treatment,the incidence of blood coagulation in the observation group was lower than that of the control group,and the nursing satisfaction of the observation group and the control group were 92.50% and 75.00% respectively,with significant differences.Conclusions The application of quality control early warning system in the continuous blood purification treatment of critically ill children has a high clinical value,which can not only effectively reduce the alarm frequency and the incidence of filter coagulation,but also significantly prolong the treatment time,and it is worth promoting in the future treatment process.

目的 分析中枢神经系统孤立性纤维瘤(SFT)11例患者的临床特点、影像学及病理学表现、手术结果。方法 回顾性分析2013年—2021年于广州医科大学附属第二医院神经外科接受手术并经病理检查证实为中枢神经系统SFT的11例患者的临床资料。结果 11例患者主要症状为头晕、头痛或肢体乏力。MRI:病灶主要表现为T1WI等-低信号,T2WI混杂信号或等-稍高信号。病理组织学:镜下表现为疏密不一的梭形肿瘤细胞呈交替排列。免疫组化:肿瘤细胞主要表现为STAT6阳性、CD34阳性等特点。病灶全切除患者预后较好,病灶次全切除或既往有SFT复发病史患者容易再次复发。结论 中枢神经系统SFT患者MRI T2WI信号有助于诊断,但是最终诊断依靠病理学检查。手术切除是首选的治疗方式。

Objective To analyze the clinical features,radiological and pathological manifestations and surgical results of 11 patients with solitary fibrous tumors (SFT) of the central nervous system (CNS). Methods The clinical data of 11 patients with SFT of CNS confirmed by pathological examination in the Neurosurgery Department of the Second Affiliated Hospital of Guangzhou Medical University from 2013 to 2021 were retrospectively analyzed. Results The main symptoms of 11 patients were dizziness,headache or extremity weakness. MRI: the lesions mainly showed iso-low signal on T1WI,mixed signal or iso-slightly high signal on T2WI. Histopathological features: microscopically,there were alternating rows of spindle tumor cells with irregular density. Immunohistochemistry showed that the tumor cells were STAT6 positive,CD34 positive,etc. Patients with total resection of the lesion had a better prognosis. Patients with subtotal resection of the lesion or previous history of SFT relapse were prone to relapse. Conclusions MRI T2WI signals in patients with CNS SFT were helpful for diagnosis,but the final diagnosis depended on pathology. Surgical excision is the preferred treatment.

目的 探讨家庭药师与药物治疗管理对签约患者用药依从性及不合理用药干预效果。方法 选取2017年3月—2021年3月我院收治的慢性病患者100例作为前瞻性研究对象,按照随机余数法分为对照组和研究组各50例。其中,对照组实施首次随访调查,收集患者健康信息建立用药档案,末次随访评价。研究组采用收集患者健康信息,建立用药档案,填写调查表,对在用的药物治疗方案进行评价,家庭药师与家庭医生协作共同干预或直接干预,制定具体的解决方案,帮助患者达到治疗目标。比较2组患者干预前后的药物依从性、生活质量及用药情况的变化。结果 干预前,2组患者的药物依从性评分比较无统计学意义(P ＞0.05),干预后,2组患者药物依从性评分比较随时间增加而改善,而研究组的药物依从性评分显著高于对照组,统计学显示差异有统计学意义(P＜0.05)。2组患者的选择合理、给药频率合理、滴定合理、换药合理、联合用药合理均有明显改善且研究组多于对照组,比较差异有统计学意义(P＜0.05)。结论 家庭药师及药物治疗管理干预能够有效提高患者用药依从性及生活质量,改善用药情况,对慢性病患者干预具有一定参考价值。

Objective To explore intervention the effect of family pharmacist and medication management on medication compliance and unreasonable drug use in contracted patients. Methods A total of 100 patients with chronic diseases from March 2017 to March 2021 in our hospital were selected as prospective study subjects. According to the random remainder method,they were divided into control group and research group with 50 cases in each group. Among them,the control group was surveyed in the first followed-up,and the health information of patients was collected to establish drug use files,and evaluation was performed in the final follow-up. Family pharmacists and family physicians intervened together or directly to formulate specific solutions to help patients achieve the treatment goals and explain the treatment goals. The changes of medication compliance,quality of life and drug use before and after intervention were compared between the two groups. Results Before the intervention,the medication compliance scores of the two groups were not significantly different (P>0.05).After the intervention,the medication compliance scores of the two groups improved with time,while the medication compliance scores of the research group were significantly higher than the control group,statistics analysis showed that the difference was significant (P<0.05).The reasonable selection,the reasonable frequency,the reasonable titration,the reasonable drug change,and the reasonable combined medication in research group were significantly more than the control group,and the differences were statistically significant (P<0.05).Conclusions Family pharmacist and medication management intervention could effectively improve medication compliance and quality of life of patients,improve drug use,had a certain reference value for chronic disease patients.

目的 探究青少年首发抑郁症患者治疗中联合应用艾司西酞普兰与重复经颅磁刺激(rTMS)的总疗效及应用价值。方法 选取东莞市第七人民医院2020年5月—2021年10月80例青少年首发抑郁症患者,参考“数字双盲法”,分为对照组和观察组(各40例)2组,对照组接受伪rTMS+艾司西酞普兰治疗,观察组接受rTMS+艾司西酞普兰治疗。评价指标:临床总疗效、抑郁评分(17项汉密尔顿抑郁量表,HAMD-17)、认知功能评分(威斯康星卡片分类测验,WCST)、生活质量(SF-36评分),不良反应发生率(副反应量表,TESS)。结果 观察组患者总有效率95.00%较对照组80.00%明显高(P＜0.05);且2组不良反应率比较(P＞0.05)。观察组治疗1周、2周、4周HAMD-17评分均较对照组低,同时治疗4周后WCST项目中完成分类评分较对照组更高(P＜0.05)。观察组SF-36(角色、社会、躯体、认知)评分均较对照组高(P＜0.05)。结论 青少年首发抑郁症患者,在艾司西酞普兰用药基础上联合rTMS,可获取更为显著的治疗效果,控制病情进展,减轻抑郁症状,同时对认知功能无影响,促进生活质量大幅度提高,且用药安全性有保障。

Objective To explore the total efficacy and application value of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of adolescent patients with first-episode depression.Methods A total of 80 adolescent patients with first-episode depression in Dongguan Seventh People's Hospital from May 2020 to October 2021 were selected.Referring to the “digital double-blind method”,they were divided into control group and observation group (40 cases each).The control group was treated with pseudo rTMS and escitalopram,and the observation group was treated with rTMS and escitalopram.Evaluation indexes: total clinical efficacy,depression score (17-item Hamilton Depression Scale,HAMD-17),cognitive function score (Wisconsin Card Sorting Test,WCST),quality of life (SF-36 score),adverse reaction rate (Treatment Emergent Symptom Scale,TESS).Results The total effective rate of 95.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05); the incidence of adverse reactions was compared between the two groups (P>0.05).The HAMD-17 scores of the observation group at 1 week,2 weeks and 4 weeks were significantly lower than those of the control group.At the same time,the classification scores of WCST items after 4 weeks of treatment were higher in observation group (P<0.05).The SF-36 (role,society,body and cognition) scores in the observation group were higher than those in the control group (P<0.05).Conclusions Adolescent patients with first-episode depression treated with rTMS on the basis of escitalopram can obtain more significant therapeutic effect,control the progress of the disease,reduce depressive symptoms,have no effect on cognitive function,greatly improve the quality of life,and ensure the safety of medication.

目的 研究麻醉恢复室(PACU)全麻患者气管内吸痰的最佳时机与按需吸痰的可行性。方法 选取2021年6月—2021年10月行经口气管插管静吸复合全身麻醉的择期手术患者240例,随机分为A组(拔管前吸痰组)、B组(入室吸痰组)、C组(入室按需吸痰组)3组,每组80例。A组苏醒时拔除导管前常规气道内及口腔吸痰;B组入PACU时提前气道内及口腔吸痰,苏醒时拔除导管,拔管后清理口腔;C组入室后参考吸痰指征评估患者气道分泌物,有吸痰指征患者吸痰,无吸痰指征者不吸痰,苏醒时拔除导管后清理口腔。分别记录患者术后入PACU时、吸痰及拔管后1 min患者的心率、血压、患者因气管刺激引起的呛咳、恶心呕吐及气道痉挛等发生例数,记录躁动评分、术后咽喉痛评分并进行评估。结果 A组与B组比较,每位患者均有吸痰,A组患者心率、血压、血氧饱和度,在吸痰后及拔管后较B组变化幅度大,差异均有统计学意义(P <0.05),气道应激反应方面,C组有20例患者按需吸痰,3组患者均未出现气道痉挛患者,A组有2例患者因拔管时剧烈呛咳引起呕吐,C组呛咳例数低于A组和B组,差异有统计学意义(P <0.05),气道刺激引起的躁动及术后咽喉疼痛C组低于A组,差异有统计学意义(P <0.05)。结论 患者在入室时按需吸痰,拔管时不再吸痰,可减少患者的心血管及气道应激反应,减少术后咽痛。

Objective To investigate the best time for endotracheal suction and the feasibility of on-demand suction in general anesthesia patients of post anesthesia care unit (PACU).Methods A total of 240 selective surgical patients who underwent oral endotracheal intubation with general anesthesia from June 2021 to October 2021 were selected.They were randomly divided into group A (sputum suction before extubation),group B (sputum suction in the room),and group C (in-room sputum suction on demand),80 cases in each group.In group A,routine airway and oral sputum suction was performed before removing the catheter when the patients were waking up.Group B had sputum sucked in the airway and mouth before entering the PACU,removed the catheter when waking up,and cleaned the oral cavity after extubation.In group C,the patients were assessed with reference of suction indications after entering the room.Sputum suction was performed for those with indications,but not for those without indications,and the mouth was cleaned after removing the catheter when awaken.Patient's heart rate,blood pressure,coughing,nausea and vomiting and airway spasm caused by tracheal irritation in 1 minute after suction and extubation were recorded after the patients entered the PACU.The tremor score and sore throat score were recorded and analyzed.Results Comparing group A with group B,each patient had sputum suction.The heart rate,blood pressure,and oxygen saturation of group A changed more significantly than group B after sputum suction and extubation (P<0.05).In terms of airway stress response,20 patients in group C needed suction,none in the three groups had airway spasm.Two patients in group A had vomiting due to severe coughing during extubation.The patients of coughing in group C were significantly less than that of group A and group B,respectively (P<0.05).The dysphoria caused by airway stimulation and postoperative throat pain in group C was significantly lower than that of group A (P<0.05).Conclusions The patient on-demand suction when enter the room,and no suction when extubation,can reduce the patient's cardiovascular and airway stress response and reduce postoperative sore throat.

目的 总结新生儿红斑狼疮(NLE)的临床特征和预后,提高对NLE的认识。方法 回顾分析2015年1月—2020年12月在广州市妇女儿童医疗中心住院诊治的19例NLE的临床资料,并进行文献复习。结果 收集19例新生儿红斑狼疮,男10例,女9例。皮肤受累者19例;心血管系统受累者7例,其中心电生理异常7例:Ⅲ度房室传导阻滞(AVB)2例,交界性心律1例,Ⅱ度AVB 2例,完全性左束支传导阻滞(CLBBB)1例,T波低平1例;扩张型心肌病(DCM)1例;房间隔缺损1例。血液系统受累者3例;消化系统受累者7例。患儿抗SSA或抗SSB阳性18人,抗核抗体阳性18人,dsDNA阳性2人,抗RNP阳性3人。孕母产前诊断系统性红斑狼疮4例,干燥综合征8例,未分化结缔组织病1例,无任何临床症状6例(有无诊断疾病),其中10例予糖皮质激素治疗。随访时间5月~62月,随访18例。心血管系统受累者的预后差异大,2例Ⅲ度AVB予心脏起搏器治疗,1例交界性心律者建议安装起搏器。1例CLBBB并DCM者的内科治疗效果差。2例Ⅱ度AVB 者无明显临床症状。T波低平者复查为正常。随访中未发现患儿及其母亲有新发自身免疫性疾病。结论 新生儿红斑狼疮临床表现以心血管系统受累为突出特征,其房室结外病变需引起关注。患儿和其母亲的长期随访非常重要。

Objective To summarize the clinical features and prognosis characteristics of neonatal lupus erythematosus (NLE).Methods The clinical data of 19 cases of NLE who were hospitalized in Guangzhou Women and Children's Medical Center from January 2015 to December 2020 were retrospectively analyzed,and the literature was reviewed.Results A total of 19 cases of neonatal lupus erythematosus were enrolled,10 males and 9 females.There were 19 cases of cutaneous lesions; 7 cases of cardiac system involvement,including 7 cases of electrophysiological abnormalities: 2 cases of third-degree atrioventricular block (AVB),1 case of junctional heart rhythm,2 cases of second-degree AVB,1 case of complete left bundle branch block (CLBBB),1 case of low T-wave.Dilated cardiomyopathy(DCM)was found in 1 case,and atrial septal defect was found in 1 case.There were 3 cases of blood system abnormalities and 7 cases of digestive system problems.Eighteen children were positive for anti-SSA or anti-SSB test,18 were positive for ANA,2 were positive for dsDNA,and 3 were positive for anti-RNP.Four cases of mother was prenatal diagnosed with systemic lupus erythematosus,8 cases of Sjgren's syndrome,1 case of undifferentiated connective tissue disease,and 6 cases without any clinical symptoms,among them,10 cases were treated with glucocorticoids.The follow-up time varied from 5 months to 62 months,and 18 cases were followed up.The prognosis of patients with cardiac system involvement varied greatly.Two patients with third-degree AVB were treated with pacemaker,and 1 patient with junctional rhythm was recommended to install pacemaker.The patient with CLBBB and DCM had poor outcome with medical treatment.Two patients with second-degree AVB had no clinical symptoms,and the low T-wave one returned to normal.During the follow-up,no new autoimmune diseases were found in the children and their mothers.Conclusions The clinical manifestations of neonatal lupus erythematosus are prominently characterized by involvement of the cardiovascular system,and the extranodal lesion need to be paid attention to.Long-term follow-up of children and their mothers is critically important.

目的 通过分析胎盘植入检出率、胎盘植入典型声像图特征及胎盘植入患者妊娠结局,探讨彩色多普勒超声检查在前置胎盘合并胎盘植入患者诊断中的应用价值。方法 回顾性分析2016年1月—2020年11月在广州市第一人民医院分娩的100例在产前超声检查中诊断为前置胎盘孕妇的临床资料及超声诊断资料。分析彩色多普勒检查在诊断前置胎盘合并胎盘植入中的灵敏度、特异度等指标;比较分析2组孕妇间年龄、流产和剖宫产次数及是否合并凶险性前置胎盘的情况;对比分析2组孕妇间胎盘分布情况、胎盘超声评分情况,分析胎盘植入的标志性超声声像图特征;分析2组孕妇分娩并发症及结局。结果 胎盘植入检出的灵敏度72%(36/50),特异度92.6%(50/54);胎盘植入组流产和剖宫产次数高于非胎盘植入组(P<0.05),合并凶险性前置胎盘的孕妇发生胎盘植入的概率升高;胎盘植入组超声评分高于非胎盘植入组(P<0.05),胎盘内陷窝征和胎盘后间隙消失是胎盘植入的标志性声像图特征;胎盘植入组产时出血量高于非胎盘植入组(P<0.05),胎盘植入组中出现产后出血的概率也是高于非胎盘植入组(P<0.05)。结论 彩色多普勒超声检查在诊断前置胎盘合并胎盘植入中的灵敏度及特异性度均较高,胎盘内陷窝征和胎盘后间隙消失在胎盘植入诊断的检出较高,可作为判断胎盘是否植入的标志性特征。运用超声评分系统可以更加客观地评价胎盘植入的诊断,对于预测其预后有重要的价值,值得推广。

Objective To explore the value of color Doppler ultrasonography in the diagnosis of placenta previa complicated with placenta implantation by analyzing the detection rate of placenta implantation,the typical sonographic characteristics of placenta implantation and the pregnancy outcome of patients.Methods The clinical data and ultrasonic diagnosis data of 100 pregnant women with placenta previa diagnosed by prenatal ultrasound in Guangzhou First People's Hospital from January 2016 to November 2020 were analyzed retrospectively.The sensitivity and specificity of color Doppler in the diagnosis of placenta previa complicated with placenta implantation were analyzed.The age,the number of abortions and cesarean sections and whether there was dangerous placenta previa between the two groups were compared and analyzed.The placental location and placental ultrasound score between the two groups were compared and analyzed,and the characteristics of landmark ultrasound images of placental implantation were analyzed.The delivery complications and outcomes of the two groups were also analyzed.Results The sensitivity and specificity of placenta implantation were 72% (36/50) and 92.6% (50/54).The number of abortion and cesarean section in placenta implantation group was significantly higher than that in non placenta implantation group (P<0.05).The probability of placenta implantation in pregnant women with dangerous placenta previa was significantly higher.The ultrasound score of placenta implantation group was significantly higher than that of non placenta implantation group(P<0.05),intraplacental lacuna sign and disappearance of retroplacental space were the landmark ultrasonographic features of placental implantation.The amount of intrapartum hemorrhage in placenta implantation group was significantly higher than that in non placenta implantation group (P<0.05).The probability of postpartum hemorrhage in placenta implantation group was also significantly higher than that in non placenta implantation group (P<0.05).Conclusions Color Doppler ultrasonography had high sensitivity and specificity in the diagnosis of placenta previa complicated with placenta implantation,intraplacental lacuna sign and disappearance of retroplacental space had high detection rates in the diagnosis of placental implantation,which can be used as a landmark feature to judge whether placenta is implanted or not.The use of ultrasound scoring system can more objectively evaluate the diagnosis of placental implantation,which has important value in predicting its prognosis and is worthy of popularization.

目的 研究未成熟血小板分数(IPF)、高荧光未成熟血小板比例(H-IPF)指标在血流感染中的早期诊断价值。方法 选取2020年7月—2021年1月广州市第一人民医院的血培养阳性患者100例作为主要的研究对象,重症病人对照50例,健康对照50例。收集各组患者IPF、H-IPF、大型血小板比率(P-LCR)、血小板体积分布宽度(PDW)、粒/淋、粒/单指标的数值,采用单因素方差分析、构建ROC曲线的方法分析比较各组的IPF、H-IPF、P-LCR、PDW、粒/淋、粒/单比值的差异及其与血流感染效能的关系。结果 IPF、H-IPF、粒/淋、粒/单比值在血流感染组高于其他2组,差异有统计学意义(χ²分别是15.190,10.250,39.490,12.850;P<0.05),而 P-LCR、PDW在3组之间无统计学意义。其中,IPF与H-IPF对血流感染诊断效能较高,其中IPF的AUC为0.855(95% CI为0.737～0.973),H-IPF的AUC为0.845(95% CI为0.722～0.968)。结论 IPF、H-IPF与血流感染密切相关,这2个指标对血流感染患者具有一定的诊断价值。

Objective To explore the early diagnosis value of immature platelet fraction (IPF) and high fluorescent immature platelet fraction (H-IPF) in bloodstream infection.Methods A total of 100 patients with positive blood culture result from July 2020 to January 2021 in Guangzhou First People's Hospital were selected as the research objects,in the mean while,50 critically ill patients and 50 healthy patients were enrolled as two control groups.The values of IPF,H-IPF,platelet-large cell rate (P-LCR),platelet distribution width (PDW),neutrophils/lymphocytes,neutrophils/monocyte ratio of patients in each group were collected,and one-way analysis of variance and ROC curve were used to compare the data,to further analyze their relationship with the bloodstream infection.Results The IPF,H-IPF,neutrophils/lymphocytes,neutrophils/monocyte ratio in the bloodstream infection group were significantly higher than control groups,with statistical significance (χ²=15.190,10.250,39.490,12.850; P<0.05),while P-LCR and PDW had no statistical significance.Among them,IPF and H-IPF were highly effective in diagnosing bloodstream infection,the AUC of IPF was 0.855 (95% CI: 0.737-0.973) and the AUC of H-IPF was 0.845 (95% CI: 0.722-0.968).Conclusions IPF and H-IPF were closely related to bloodstream infection,and these two indicators had a certain value in diagnosing patients with bloodstream infection.

目的 探究支气管镜下肺泡灌洗并局部使用阿米卡星治疗老年支气管扩张合并感染患者的疗效及对血清炎性因子水平的影响。方法 选取我院2018年3月—2019年5月确诊支气管扩张症、合并感染的符合纳入标准的患者共64例,按照1:1比例抽签分为2组,32例纳入观察组,应用支气管镜下肺泡灌洗阿米卡星治疗;32例纳入对照组,以单纯的支气管镜下肺泡灌洗治疗。观察并比较2组患者的治疗效果、血清炎性因子水平、肺功能情况等。结果 疗效比较显示观察组的96.9%总有效率高于对照组的75.0%(P＜0.05);血清炎性因子水平在患者用药前检测无差异(P＞0.05),经过治疗后,观察组水平均优于对照组P＜0.05;经治疗后,观察组静态肺活量、补呼气量、补吸气量、用力肺活量均优于对照组,差异具有统计学意义(P＜0.05)。结论 对老年支气管扩张合并感染患者应用支气管镜下肺泡灌洗阿米卡星治疗,促进临床效果改善,患者的症状、炎症及肺功能等指标均得到明显改善,值得推广。

Objective To investigate the efficacy of bronchoscopic alveolar lavage and local application of amikacin in the treatment of elderly patients with bronchiectasis complicated with infection and its effect on the level of serum inflammatory factors.Methods A total of 64 patients with bronchiectasis complicated with infection diagnosed in our hospital from March 2018 to May 2019 were selected.They were divided into two groups evenly by proportional drawing. Thirty-two cases were included in the observation group that were treated with bronchoscopic alveolar lavage with amikacin.The other 32 cases were included in the control group that were treated with the bronchoscopic alveolar lavage only.The therapeutic effect,serum inflammatory factor level and pulmonary function of the two groups were observed and compared.Results The total effective rate of 96.9% in observation group was higher than 75.0% in control group (P<0.05).There was no difference in the levels of serum inflammatory factors before treatment (P>0.05).After treatment,the levels of the observation group were better than those of the control group (P<0.05).After treatment,the slow vital capacity,expiratory reserve volume,inspiratory reserve volume and forced vital capacity of the patients in the observation group were better than those in the control group (P<0.05).Conclusions Bronchoscopic alveolar lavage of amikacin in elderly patients with bronchiectasis complicated with infection could improve the clinical effect.The symptoms of the patients,the serum inflammatory factors and lung function of the patients were significantly improved.The treatment is worthy of promotion.