支气管肺泡灌洗技术在儿童重症支原体肺炎中的临床应用研究

Clinical study of bronchoscopy lavage treatment for severe mycoplasma pneumoniae pneumonia in children

摘要:

目的 探讨支气管肺泡灌洗技术在儿童重症肺炎支原体肺炎（SMPP）治疗中的作用。方法 选取2018年12月－2019年8月该院儿科行支气管肺泡灌洗治疗的SMPP患儿47例作为研究对象（治疗组），另选取2018年3月－2018年11月于该院儿科住院治疗的有相同支气管镜适应证、病历资料完整、未进行支气管肺泡灌洗的47例SMPP患儿作为对照组，分析两组患儿临床症状、肺部体征改善时间、应用糖皮质激素时间、住院时间、住院费用和肺部超声恢复情况。结果 治疗组患儿体温降至正常时间、肺部体征改善时间、应用糖皮质激素时间和住院天数明显少于对照组，两组比较，差异均有统计学意义（P < 0.05）。治疗组患儿出院时肺部超声恢复情况优于对照组，两组比较，差异有统计学意义（P < 0.05）。但两组患儿住院费用比较，差异无统计学意义（P > 0.05）。结论 SMPP患儿在常规治疗基础上适时应用支气管肺泡灌洗技术，可清除黏液分泌物、减轻炎症反应，保持气道通畅，明显缩短病程，有助于肺部病变恢复，在临床上具有重要的意义。

Abstract:

Objective To observe the role of bronchoscopy lavage treatment for severe mycoplasma pneumoniae pneumonia (SMPP) in children.Methods 47 children with SMPP were treated with bronchoalveolar lavage from December 2018 to August 2019 were selected as the study object (treatment group). Meanwhile, previous hospitalized patients without bronchoalveolar lavage from March 2018 to November 2018 were selected as the control group (n = 47). The clinical symptoms, improvement time of pulmonary signs, glucocorticoid application time, hospitalization time, hospitalization cost and recovery of pulmonary lesions were analyzed in the two groups.Results The febrile period, time of disappearance of rales in the lungs, the time of glucocorticoid application and the days of hospitalization in the treatment group were significantly lower than those in the control group (P < 0.05). The recovery of pulmonary ultrasound in the treatment group was better than that in the control group at discharge (P < 0.05). However, there was no significant difference in hospitalization expenses between the two groups (P > 0.05). In the treatment group, endobronchial congestion, edema, increased secretion, mucus thrombus formation and poor segmental bronchial ventilation could be seen under bronchoscopy.Conclusion In children with SMPP, the timely application of bronchoalveolar lavage technique on the basis of routine treatment can clear mucus secretions, reduce inflammatory reaction, keep airway unobstructed, shorten the course of disease, contribute to the recovery of pulmonary lesions, and play an important role.