| Background Bronchiectasis is the damage of bronchial wall muscle and elastic tissue which caused by chronic inflammation of bronchial and surronded tissues, resulted in irreversible expansion of lumen formation and deformation. as a result of the changes in the structure and damage of the cilia caused by Chronic inflammation and infection, the colonization of pathogenic bacteria is easy,and there are some limitations in conventional treatments, so we cann't realize the bactericidal effect because the low antibiotic concentration in the sputum of bronchial cavity when systemic application of antibiotics.The conventional treatment often has the limitations, such as the systemic application of antibiotics, antibiotic concentrations of the bronchial cavity very low, less than bactericidal effect. The pH, PaO2, PaCO2 in Sputum, cation of the calcium and magnesium, as well as acidic and anaerobic environment in vomica were all affect the antibacterial activity of antibiotics. it is very difficult to improve the bronchial obstruction by application of expectorant agent, Bronchodilator agent and postural drainage, and long-term use of antibiotics leading to drug resistance rising. Using bronchoalveolar lavage (BAL) therapy, through the repeated lavage and attract, make the pus drainage thorough,lead to partial purification and reduction of bacteria. Changed the living environment of bacteria.Changed the living environment of bacteria, it's better to kill the anaerobic bacteria particularly, at the same time it can dilute and exclude the secretions of cystic expansion, so that the lung infection was under control, while at the same time have a treatment to the small lung abscess, Promoted lobular atelectasis of the lung and inflammatory Reexpansion faded shadow. More importantly, the application of BAL injection has both the inside and outside treatment effects, can avoid high-dose systemic toxicity through high concentration of antibiotics are directly given to the lesion and combined given through the body.also, with bronchoscopy and sputum culture check ,there are less pollution, higher positive rate and more accurate and reliable result, to avoid confusion and misuse of medication to reduce the emergence of resistant bacteria through the use of specific medication based on examination of pathogenic bacteria. In addition, the patient's cough reflex is enhanced,and better at expectoration because the fluid irritate the local mucosal.Objective To investigate the effects of Bronchoal-veolarLavage (BAL) and local antibiotics injection on patients with bronchiectasis.Methods To recall the cases of bronchiectasis with infection in the Respiratory depatment of our hospital from January 2002 to January 2009, The patients were randomly divided into conventional treatment group (control group) and conventional therapy + bronchoalveolar lavage combined local injection therapy (observation group), 36 cases of the control group, 15 cases were male, 21 cases of women aged 32-80 years old, average 53.83±12.88 years old, 3-50 years duration, with an average 24.05±13.93 years, the symptoms increase 3-60 days, an average of 15±12.67 days. 36 cases of the observation group, 18 cases were male, 18 cases of women aged 18-78 years old, the average (54.83±10.97) years old, 2-69 years duration, the average (24.25±16.34) years, adding to 1-30 days, the average (13.92±11.99) days. Before treatment of two groups, the age, the sex, the course, the morbidity number of days and the laboratory inspection and so on, pass through statistics to be quite even not remarkable difference (P>0.05), has the commeasurability. Use SPSS 16.0 package for statistical treatment, and use X2 test for comparison of groups with count data, use t tests for comparison of groups with measurement data, P<0.05 for showing statistical significance.Results To patients with bronchiectasis, in the conventional treatment based on treatment with BAL and sensitive to local injection of drugs, can significantly enhance the effectiveness of treatment, the total effective rate compared with the control group were significantly different (P<0.05), Compared with the control group, total hospital stay was significant different (P<0.01),and significantly reduced hospitalization costs, compared with the control group were significantly different (P<0.05), with statistical significance. Compared with the control group,cough, sputum symptoms were significantly different (P<0.05), with statistical significance; Compared with the control group,the body temperature returned to normal were significantly different (P <0.05), with statistical significance ; Compared with the control group,the reduction of moist rales were significantly different (P <0.01), with statistical significance.Two sets of indicators of pre-treatment blood gas analysis (PaO2 (mmHg),SaO2(%),PaO2 /FiO2) compared no significant difference (P>0.05), after treatment, bronchoalveolar lavage group of indicators of blood gas analysis (PaO2 (mmHg),SaO2 (%),PaO2 /FiO2) significantly better than the treatment group in general, there are significant difference (P<0.05).Conclusions to the patients with bronchiectasis, in the conventional treatment based on treatment with BAL and sensitive to local injection of drugs, can significantly enhance the effectiveness,reduce hospitalization costs and the total length of stay in hospital. |
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