纤维支气管镜早期介入治疗儿童重症肺炎支原体肺炎合并肺不张的临床疗效

Clinical curative effect of early intervention treatment with fiber bronchoscope on children with severe mycoplasmal pneumoniae pneumonia and atelectasis

摘要:

目的 探讨纤维支气管镜早期介入治疗儿童重症肺炎支原体肺炎（MPP）合并肺不张的临床疗效。方法 选取2018年6月－2021年6月于该院就诊的重症MPP合并肺不张的患儿66例，采用随机数表法分为观察组（n = 33）和对照组（n = 33），所有患儿均行抗生素等常规治疗，观察组在常规治疗基础上采用纤维支气管镜介入治疗，对照组在常规治疗基础上进行吸氧监护。比较两组患儿的临床疗效、肺复张时间、退热时间、住院时间、血清超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平和不良反应发生情况。结果 观察组临床治疗有效率为93.94%，与对照组的75.76%比较，差异有统计学意义（P < 0.05）。治疗前，两组患儿的血清hs-CRP、IL-6和TNF-α比较，差异无统计学意义（P > 0.05）；治疗后，观察组血清hs-CRP、IL-6和TNF-α均明显低于对照组，差异有统计学意义（P < 0.05）。观察组术后肺复张时间、退热时间和住院时间明显短于对照组，差异有统计学意义（P < 0.05）。两组患儿不良反应发生率比较，差异无统计学意义（P > 0.05）。结论 纤维支气管镜早期介入治疗重症MPP合并肺不张患儿，能够明显提高临床疗效，缩短恢复时间，值得临床推广应用。

Abstract:

Objective To explore the clinical curative effect of early intervention treatment with fiber bronchoscope on children with severe mycoplasmal pneumoniae pneumonia (MPP) and atelectasis.Methods 66 children with severe MPP and atelectasis were enrolled from June 2018 and June 2021. According to random number table method, they were divided into observation group and control group, 33 cases in each group. All underwent routine antibiotics treatment. On this basis, observation group was treated with fiber bronchoscope for intervention treatment, while control group was treated with oxygen monitoring. The differences in clinical curative effect, recruitment maneuvers time, antipyretic time, hospitalization time, levels of serum hypersensitive C reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and the occurrence of adverse reactions were analyzed and compared between the two groups.Results The differences in response rate of clinical treatment between the observation group and control group were statistically significant (93.94% vs 75.76%) (P < 0.05). Before treatment, there was no significant difference in serum hs-CRP, IL-6 and TNF-α between the two groups. After treatment, serum hs-CRP, IL-6 and TNF-α in observation group were significantly lower than those in control group (P < 0.05). The postoperative recruitment maneuvers time, antipyretic time and hospitalization time in observation group were significantly shorter than those in control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Early intervention treatment with fiber bronchoscope can significantly improve clinical curative effect and shorten recovery time in children with severe MPP and atelectasis.