Fiber bronchoscope in treatment of elderly patients with hypostatic pneumonia

Abstract

Objective To explore the clinical value of fiber bronchoscope in the treatment of elderly patients with hypostatic pneumonia.Methods 100 elderly patients with hypostatic pneumonia were selected from the Department of Respiratory Medicine at Lecong Hospital of Shunde,Foshan from May,2012 to May,2014.According to different treatment plans,the patients were divided into a treatment group(n=50)and a control group(n=50).In addition of routine treatment,the treatment group accepted sputum aspiration and lavage with bronchofibroscope; the specimens were sampled via protected specimen brush (PSB) or lavage for bacterial culture.The control group received routine treatment; sputum specimens were sampled routinely for bacterial culture.Antibiotics were used and adjusted according to the results of the bacterial culture and the drug sensitive test was carried out in both groups.The therapeutic effect,mortality,results of bacterial culture,hospital stays,and adverse effects of the treatment with fiber bronchoscope were observed.Results The total effective rate and the mortality were 84％ and 8％ in the treatment group and were 64％ and 28％ in the control group,with statistical differences(P ＜ 0.05).88％ patients of the treatment group and 44％ of the control group were positive in bacterial culture.82.0％ patients of the treatment group and 86.4％ of the matched group were positive in Gram negative pathogenic bacteria.After the treatment,the bacterial negative rate was 86.4％ in the treatment group and was 45.5％ in the control group,with a statistical difference(P ＜ 0.05).The mean time of hospital stay was (18.42 ± 4.77) days in the treatment group and was (23.06 ± 6.08) days in the control group,with a statistical difference(P ＜ 0.05).No severe adverse reactions occurred during the treatment with the fiber bronchoscope.Conclusions Fiber bronchoscope in the treatment of elderly patients with hypostatic pneumonia is effective and safe and can reduce the mortality,increase the detectable rate of pathogenic bacteria,shorten the hospital stay,and reduce the hospitalization expense.It is worth being clinically generalized. Key words: Fiber bronchoscope;  Sputum aspiration and lavage;  Bacterial culture;  Elderly patients with hypostatic pneumonia;  Treatment