纤维支气管镜诊断小儿支原体肺炎的价值

Analysis of clinical value of fiberoptic bronchoscopy in the diagnosis and treatment of children with mycoplasma pneumonia

目的探讨纤维支气管镜诊断小儿支原体肺炎的应用价值。方法对我院收治的170例小儿支原体肺炎患儿的临床资料进行分析。结果 138例(81.18%)支原体肺炎患儿单份血清特异性MP-IgM抗体滴度大于1∶160。151例(88.82%)患儿MP-DNA检测阳性。支气管肺泡灌洗液细菌培养得阳性菌株共23株。170例支原体肺炎患儿均进行纤维支气管镜检查,在镜下均可见支气管内膜炎症表现,病变部位可有黏膜充血水肿并附着分泌物,45例(26.47%)患儿支气管开口处可见痰堵,患儿通气不畅,24例(14.12%)患儿管腔内可见黄脓性痰栓,18例(10.59%)患儿支气管开口出现炎性狭窄,14例(8.24%)患儿支气管分支开口异常,11例(6.47%)患儿管壁黏膜呈现小结节样突起。结论对小儿支原体肺炎早期应用纤维支气管镜检查,提高诊断效率,治疗预后有重要意义。

Objectives To observe the clinical application value of fiberoptic bronchoscopy in the diagnosis of children with mycoplasma pneumonia.Methods The clinical data of 170 children with mycoplasma pneumonia in our hospital were retrospectively analyzed.Results A single serum specific MP-IgM antibody titer of 138 children（81.18%） with mycoplasma pneumonia was more than 1 ∶ 160.The positive MP-DNA was detected in 151 children（88.82%）.There were 23 strains of positive strains cultivated by bronchoalveolar lavage fluid bacterial.170 children with mycoplasma pneumonia were checked with fiberoptic bronchoscopy,and endobronchial inflammation were found and the lesion site had mucosal hyperemia edema and attached secretions.Bronchial openings of 45 children（26.47%） had sputum blocking and poor ventilation.There was yellow purulent sputum bolt within the lumen of 24 children（14.12%）.Bronchial openings of 18 children（10.59%） occurred inflammatory stricture.Bronchial branch openings of 14 children（8.24%） were abnormal.Tube wall mucosa of 11 children（6.47%） presented small nodular protrusion.Conclusion Fiberoptic bronchoscopy can improve the diagnostic efficiency on children with pediatric mycoplasma pneumonia at early stage,which also has an important significance on the prognosis.