纤支镜灌洗疗法在儿童重症支原体肺炎中的应用及其发热期疗效观察

Application of branchofiberoscope lavage therapy and its effect on febrile stage of children with severe mycoplasmal pneumonia

目的 探讨纤维支气管镜灌洗疗法在儿童重症支气管肺炎中的应用价值,观察重症支气管肺炎急性期发热时灌洗疗法的临床疗效。方法 符合诊断标准的33例患儿,按家长意愿分为药物组和纤支镜组。药物组给予抗感染、退热、止咳等药物对症治疗。纤支镜组在药物治疗（药物治疗同药物组）的基础上联合使用纤支镜灌洗治疗。治疗5~7天后,观察两组患儿的临床疗效及症状、体征缓解情况。纤支镜组按治疗时是否处于发热期又分为发热组和对照组,同时观察发热组和对照组患儿症状、体征控制时间及住院天数。结果 纤支镜组疗效优于药物组,纤支镜组咳嗽、肺部音缓解时间明显短于药物组,统计学分析,均有显著性差异（P〈0.05）。同时,发热组控制咳嗽时间、肺部音消失时间及住院天数均短于对照组,经统计学比较,亦有显著性差异（P〈0.05）。结论 纤支镜灌洗疗法能显著提高重症支原体肺炎患儿的治疗效果,促进临床症状及肺部体征改善。同时,对于急性期仍有发热时行纤支镜灌洗疗法,可提高疗效,改善预后。

Objective To study the application value of branchofiberoscope lavage therapy and to observe its effect on febrile stage of children with severe mycoplasmal pneumonia. Methods 33 children with severe mycoplasmal pneumonia were divided into the medicine group and the branchofiberoscope group according to their wish. The medicine group was given anti - infection, antipyretic, and relieve cough medicines. The branchofiberoscope group was given the same medicines as the medicine group, in addition, with a combination of branchofiberoscope lavage therapy. After 5 -7 days＇ treatment, their symptoms and physical signs were observed to estimate the clinical effect. The branchofiberoscope group was also divided into the febrile group and the control group according to febrile stage. The controlling time of the two groups＇symptoms and physical signs as well as their hospitalization days were also observed. Results The effect of branchofiberoscope group was superior to the medicine group, besides, the relief time of cough and pulmonary rales of the former were obviously shorter than the latter. There was significant difference between the two groups （ P 〈 0.05 ）. For the febrile group, the time they spent in controlling coughs and curing pulmonary rales as well as their hospitalization days were all shorter than those in the control group （ P 〈 0. 05 ）. Conclusion The branchofiberoscope lavage therapy can significantly improve the effect of treatment in children with severe mycoplasmal pneumonia, and promote the improvement of clinical symptoms and pulmonary signs. Furthermore, for the children with fever at acute stage, the branchofiberoscope lavage therapy can also improve the efficacy and prognosis.