纤维支气管镜在大叶性支原体肺炎中的应用价值

Application value of fiberoptic bronchoscopy in lobar mycoplasma pneumonia

目的探讨纤维支气管镜对儿童大叶性肺炎支原体肺炎（mycoplasma pneumoniae pneumoniaMPP）的应用价值。方法回顾性分析我科住院的大叶性MPP患儿126例，分为对照组54例和观察组72例。对照组取深部痰标本，观察组在纤维支气管镜下进行支气管肺泡灌洗（bronchoalveolarlavage，BAL），取支气管肺泡灌洗液（bronchoalveo larlavage fluid，BALF），两组标本均进行MP—DNA检测，比较两组阳性率及各年龄MP—DNA阳性率构成比。第4周时比较两组的发热时间、咳嗽消失时间、肺部体征消失时间、两组X线肺部病变完全吸收例数，并评价两组治疗效果。结果MP—DNA阳性率比较，两组差异有统计学意义（P〈0．05）；各年龄段MP—DNA阳性检出率观察组均较对照组高，以7～9岁MP—DNA检出率最高；两组发热时间、咳嗽消失时间、肺部体征消失时间、胸片完全吸收比较，差异有统计学意义（P〈0．01）。结论纤维支气管镜能早期明确诊断MPP，同时BAL能够显著提高大叶性MPP疗效，具有临床应用价值。

Objective To observe the application value of fiber bronchoscope in lobar mycoplasma pneumonia. Methods A retrospective analysis was performed for 126 mycoplasma pneumoniae pneumonia patients, who had ever been hospitalized in our department, 54 and 72 patients were chosen as the observation group and the control group respectively. Sputum of deep respiratory tract in the control group and bronchoalveolar lavage fluid performed by fiber bronchoscope in the observation group were sent to conduct MP-DNA examination., then positive detection rate and the constituent ratio among different age of MP-DNA were compared between two groups. Then the fever time, cough disappearance time, pulmonary rale disappearance time were compared, and the case of the lung inflammation absorption after treatment was counted at the fourth week after therapy between the two groups, then the therapeutic effects were evaluated between the two groups. Results The positive rate of MP-DNA was compared, there was significant difference between the two groups （P 〈 0.05）.The positive rate of MP-DNA among different age was higher in the ob- servation group than in the in the control group, and the age bracket of the highest positive rate was 7-9 years old in both group, the fever time ,cough disappearance time, the extinction time of physical sign and the case of the lung in- flammation absorption after treatment, there was significant difference between the two groups （P 〈 0.01 ）. Conclusion Mycoplasma pneumonia can be early definitely diagnosed by fibrobrochoscope, meanwhile, bronchoalveolar lavage can significantly improve the therapeutic efficacy of lobar mycoplasma pneumonia, and has clinical application value.