基于降低感染风险的术前鼻腔冲洗在支气管镜检查中的应用与探究
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孟玲，范新苗
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湖北医药学院直属十堰市人民医院，湖北十堰，442000
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摘要：目的 评估术前鼻腔冲洗降低支气管镜检查术后感染风险的效果，明确其对感染发生率、炎症因子 及鼻黏膜纤毛功能的影响，为围术期感染防控提供依据。方法 选取 2024 年1 月-2025 年1 月需行支气管 镜检查的100 例患者，随机分实验组（50 例，术前鼻腔冲洗+常规流程）与对照组（50 例，仅常规流程）。 冲洗方案为0.9%生理盐水，术前3 天每日早晚各1 次。比较两组感染指标（发热率、呼吸道感染率、痰培 养病原菌检出率）、炎症因子（CRP、WBC、NEUT%）、鼻黏膜纤毛功能（糖精清除时间、清除率、清除 速度）及不良反应。结果 实验组术后发热率（8.00%）、呼吸道感染率（3.20%）、病原菌检出率（2.00%） 均低于对照组（24.00%、8.70%、6.00%），感染患者发热持续时间（27±0.5）h 短于对照组（54±0.5）h（P<0.05）； 术后3 天，实验组CRP（10.9±0.5 mg/L）、WBC（7.8±0.6×10??/L）、NEUT%（58.2±3.1%）低于对照 组（21.6±0.5 mg/L、11.5±0.8×10??/L、72.5±3.5%）（P<0.05）；实验组糖精清除时间（22.5±3.2 min） 短于对照组（28.6±4.1 min），清除率（73.8±5.6%）、清除速度（8.9±1.1 mm/min）高于对照组（67.3± 4.3%、7.4±1.0 mm/min）（P<0.05）；两组不良反应发生率（2.30% vs 6.00%）无差异（P>0.05）。结论 术 前鼻腔冲洗可降低支气管镜检查术后感染风险，减轻炎症，改善鼻黏膜纤毛功能，安全性高，值得推广。
关健词：术前鼻腔冲洗；支气管镜检查；感染风险；炎症因子；鼻黏膜纤毛功能
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Application and Exploration of Preoperative Nasal Irrigation in Bronchoscopy Based on Reducing Infection Risk
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Ling Meng,Xinmiao Fan
Shiyan People's Hospital, directly affiliated to Hubei University of Medicine, Shiyan Hubei 442000, China
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Abstract：Objective To evaluate the effect of preoperative nasal irrigation on reducing postoperative infection risk of bronchoscopy, clarify its impact on infection rate, inflammatory factors and nasal mucosal ciliary function, and provide basis for perioperative infection prevention. Methods 100 patients undergoing bronchoscopy from Jan 2024 to Jan 2025 were randomly divided into experimental group (50 cases, preoperative nasal irrigation + routine process) and control group (50 cases, routine process only). Irrigation protocol: 0.9% normal saline, twice a day for 3 consecutive days before operation. Infection indicators (fever rate, respiratory infection rate, pathogen detection rate in sputum culture), inflammatory factors (CRP, WBC, NEUT%), nasal mucosal ciliary function (saccharin clearance time, rate, speed) and adverse reactions were compared.Results Postoperative fever rate (8.00%), respiratory infection rate (3.20%) and pathogen detection rate (2.00%) in experimental group were lower than those in control group (24.00%, 8.70%, 6.00%); fever duration of infected patients (27±0.5 h) was shorter than that in control group (54±0.5 h) (P<0.05). On the 3rd postoperative day, CRP (10.9±0.5 mg/L), WBC (7.8±0.6×10?/L) and NEUT% (58.2±3.1%) in experimental group were lower than those in control group (21.6±0.5 mg/L, 11.5±0.8×10?/L, 72.5±3.5%) (P<0.05). Saccharin clearance time (22.5±3.2 min) in experimental group was shorter than that in control group (28.6±4.1 min); clearance rate (73.8±5.6%) and speed (8.9±1.1 mm/min) were higher than those in control group (67.3±4.3%, 7.4±1.0 mm/min) (P<0.05). No difference in adverse reaction rate (2.30% vs 6.00%) (P>0.05). Conclusion Preoperative nasal irrigation can reduce postoperative infection risk of bronchoscopy, alleviate inflammation, improve nasal mucosal ciliary function with high safety, worthy of promotion.
Keywords : Preoperative Nasal Irrigation; Bronchoscopy; Infection Risk; Inflammatory Factors; Nasal Mucosal Ciliary Function
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