探讨经支气管镜灌洗治疗支气管扩张合并感染的疗效。

选取2016年7月至207年12月本院收治的支气管扩张合并感染者126例为研究对象，根据随机数字法分为观察组和对照组各63例。对照组患者给予抗感染、体位引流、平衡水电解质等常规内科治疗；观察组患者于常规治疗的基础上，给予经奥林巴斯BF-260电子纤维支气管镜支气管肺泡灌洗联合局部注药治疗。观察两组患者临床症状及体征（热退时间、咳嗽咯痰消失时间、啰音消失时间、住院时间）、动脉血气指标（PaO₂、PaCO₂、SaO₂、FiO₂）、免疫功能指标（IgA、IgG、IgM、CD4⁺/CD8⁺）、炎症因子指标（CRP、TNF-α、IL-6）及疗效情况（显效、有效、无效）。

研究组患者热退时间为（4.22 ± 1.12）d、咳嗽咯痰消失时间为（6.17 ± 0.59）d、啰音消失时间为（7.12 ± 4.05）d、住院时间为（10.2 ± 2.7）d，对照组患者热退时间为（5.83 ± 0.72）d、咳嗽咯痰消失时间为（11.29 ± 0.85）d、啰音消失时间为（10.29 ± 3.12）d、住院时间为（11.9 ± 3.2）d，两组患者差异具有统计学意义（t = 9.578、39.276、4.922、3.223，P均< 0.01）。研究组患者动脉血气指标（PaO₂、PaCO₂、SaO₂、FiO₂）显著优于对照组，差异具有统计学意义（t = 4.044、19.090、6.329、5.477，P均< 0.001）；研究组患者免疫功能指标（IgA、IgG、IgM、CD4⁺/CD8⁺）均优于对照组，差异具有统计学意义（t = 4.433、6.667、3.577、5.416，P均< 0.001）。研究组患者炎症控制效果优于对照组，差异具有统计学意义（P < 0.001）。研究组患者治疗有效率（74.6%）优于对照组（47.6%），差异具有统计学意义（χ² = 9.651、P = 0.002）。

在治疗支气管扩张并感染疗效方面，相比保守治疗，经支气管镜灌洗可改善临床症状及体征，纠正血气指标不合格，降低血清炎症因子水平，提升血清免疫细胞水平及显著提高有效率，优势明显。

To investigate the curative effect of bronchoscopy lavage for bronchiectasis complicated with infection.

Total of 126 cases of bronchiectasis complicated with infection were selected as the study subjects from July 2016 to December 2017 in our hospital, and were divided into observation group and control group according to the random number method (63 cases in each group). Patients in the control group were treated with routine internal medicine such as anti-infection, postural drainage and balanced electrolyte. On the basis of routine treatment, patients in the observation group were given a combination of local injection therapy with the Olympus BF-260 electron fiber bronchoscopic bronchial pulmonary alveolar lavage. The clinical symptoms and signs (thermal annealing time, cough and expectoration vanished, then disappeared time, the length of time), arterial blood gas indexex (PaO₂, PaCO₂, SaO₂, FiO₂), immune function indexex (IgA, IgG, IgM, CD4⁺/CD8⁺), inflammatory factor indexes (CRP, TNF-α, IL-6) and curative effects (significant effect, effect and invalid) were compared between patients in the two group, respectively.

The time of heat retreat, coughing and phlegm disappearence, hospitalization, rale disappearance of patients in the observation group were (4.22 ± 1.12) d, (6.17 ± 0.59) d, (7.12 ± 4.05) d and (10.2 ± 2.7) d, while those were (5.83 ± 0.72) d, (11.29 ± 0.85) d, (10.29 ± 3.12) d and (11.9 ± 3.2) d in the control group, with significant differences (t = 9.578, 39.276, 4.922, 3.223; all P < 0.001). The arterial blood gas indexes (PaO₂, PaCO₂, SaO₂, FiO₂) of patients in the observation group were significantly better than those of the control group, with significant differences (t = 4.044, 19.090, 6.329, 5.477; all P < 0.001). The immune function indexes (IgA, IgG, IgM, CD4⁺/CD8⁺) of the patients in the observation group were better than those in the control group, with significant differences (t = 4.433, 6.667, 3.577, 5.416, all P < 0.001). The inflammatory control effect of patients in the study group was better than that in the control group, with significant difference (P < 0.001). The effective rate of treatment in the observation group (74.6%) was better than that of the control group (47.6%), with significant difference (χ² = 9.651, P = 0.002).

In the treatment of bronchiectasis and infection, compared with conservative treatment, bronchial lavage could improve the clinical symptoms and signs, correct the inappropriate blood gas indexes, reduce the levels of serum inflammatory factors, and improve the levels of serum immune cells and improve the efficiency, with significant advantages.