经纤维支气管镜糜蛋白酶灌洗治疗小儿肺炎支原体肺炎合并肺不张

Chymotrypsin lavage by fiberoptic bronchoscopy in the treatment of children with mycoplasma pneumonia combined with atelectasis

目的探讨经纤维支气管镜糜蛋白酶灌洗治疗小儿支原体肺炎合并肺不张的效果。方法选取2009年9月～2010年5月住院患儿60例，临床确诊为支原体肺炎合并肺不张，分为对照组和灌洗组。对照组30例，常规予抗支原体、抗感染、祛痰、雾化吸入治疗。灌洗组30例予糜蛋白酶加0．9％氯化钠溶液稀释到0．5mg／ml，在纤维支气管镜下每次2ml，分次灌洗到肺不张处，其他治疗同对照组。在治疗第三天和第十天复查全胸片，以肺不张改善情况判断疗效。结果灌洗组VS对照组：3天有效率（完全吸收＋部分吸收）93．3％VS 26．7％；10天有效率（完全吸收＋部分吸收）100％VS 83．5％，均具有显著差异（P分别为0．00，0．02）。结论小儿支原体肺炎合并肺不张经纤维支气管镜糜蛋白酶灌洗治疗能更好地改善肺不张，提高疗效，缩短病程。

Objective The study was designed to explore the effect of chymotrypsin lavage by fiberoptic bronchoscopy in the treatment of children with mycoplasma pneumonia combined with atelectasis. Methods 60 cases of mycoplasma pneumonia combined with atelectasis from September in 2009 to May in 2010 were divided into lavage group with 30 cases and control group with 30 cases. Chymotrypsin were diluted to 0.5 mg/ml, and were lavaged to atelectasis department 2 ml each through fiberoptie bronchoscopy. The control group were treated by anti - mycoplasma, antibiotics, expectorants, and aerosol inhalation routinely. Chest radiographs were reviewed after the treatment of 3 days and 10 days, and efficacy was estimated in the improvement of the situation of atelectasis. Results lavage group vs control group, effectiveness after the treatment of 3 days（Completely absorbed and partly absorbed）93.3% vs 26.7% （ P = 0.00,0.02）. Effectiveness after the treatment of 3 days（Completely absorbed and partly absorbed）100% VS 83.5% （P = 0.02）. Conclusion The method of chymotrypsin lavage by tiber＇optic bronchoscopy in the treatment of children with mycoplasma pneumonia combined with atelectasis can ameliorate conditions and improve the efficacy.