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目的:分析糖尿病合并肺脓肿临床特点,总结诊疗经验。方法:对收治糖尿病并肺脓肿患者,给予保守治疗,滴注或配合吸入药物严格控制血糖,抗厌氧菌治疗,体位引流,营养支持,对症治疗,疗程持续3~5个月。结果:痊愈47例、有效9例,无转手术治疗者;痊愈者平均治疗时间(3.2±0.3)个月,4例患者转院治疗,5例身体状况较差的老年患者表示疗效已达预期,于家中用药并自我管理,病情稍缓;治疗后患者空腹血糖(9.3±1.8)mmol/L、白细胞计数(7.9±0.8)109/L低于治疗前(15.3±3.8)mmol/L、(10.2±0.4)109/L,血清白蛋白(34.5±3.1)g/L、血红蛋白(120.3±15.8)g/L高于治疗前(25.3±3.5)g/L、(83.3±3.3)g/L,差异具有统计学意义(P<0.05)。结论:糖尿病并肺脓肿临床治疗路径基本成熟,采取体位引流、抗菌治疗等方法积极消除脓肿,严格控制血糖,以控制糖尿病病情,收效多良好,同时综合调节患者身体机能,配合系统性健康宣教,以提高患者院外自我管理能力,抑制肺脓肿复发与糖尿病进展。
Objective: To analyze the clinical features of diabetic pulmonary abscess and summarize the experience of diagnosis and treatment. Methods: To treat patients with diabetes mellitus and pulmonary abscess, conservative treatment, instillation or inhalation of drugs to strictly control blood glucose, anti-anaerobic bacteria treatment, body drainage, nutritional support, symptomatic treatment, treatment duration 3 to 5 months. Results: The recovery of 47 cases, effective in 9 cases, without surgery; cured average treatment time (3.2 ± 0.3) months, 4 patients transferred to hospital, 5 cases of poor health in elderly patients that the effect has reached expectations, After treatment, the fasting blood glucose (9.3 ± 1.8) mmol / L and the white blood cell count (7.9 ± 0.8) 109 / L were lower than those before treatment (15.3 ± 3.8) mmol / L and (83.3 ± 3.3) g / L before treatment (25.3 ± 3.5) g / L and before treatment (± 0.4) The difference was statistically significant (P <0.05). Conclusion: The clinical treatment of diabetic abscess and lung abscess is basically mature. Abdominal drainage and antibacterial therapy are adopted to eliminate abscess and control blood sugar strictly to control the condition of diabetes. In addition, it is effective in regulating diabetes and systemic health education. To improve patient self-management ability of the hospital, inhibit the recurrence of lung abscess and diabetes progression.