应用电子支气管镜治疗儿童重症支原体肺炎的效果分析

Treatment of children with severe Mycoplasma pneumonia by electronic bronchoscope

目的探讨电子支气管镜在儿童重症支原体肺炎治疗中的效果,并提供有效的治疗方法,为其广泛应用提供理论依据。方法选择2013年10月-2015年10月医院呼吸内科收治并确诊为重症支原体肺炎患儿200例,均分为观察组和对照组,对照组仅给予传统方法治疗,观察组给予传统治疗方法的同时,应用电子支气管镜治疗,对比分析常规和肺泡灌洗液两种标本的支原体检出率,分析比较两组患者临床症状、辅助检查等恢复情况。结果在给患儿进行电子支气管镜的治疗过程中,即过声门、目标部位和检查结束时患者的血氧饱和度(SpO2)与检查前均有明显变化(P<0.05),而心率(HR)与检查前均无明显变化;对观察组患儿不同标本的肺炎支原体进行检测,取肺泡灌洗液为标本的肺炎支原体检测阳性率为41.00%,常规标本的肺炎支原体检测阳性率为22.00%;观察组患儿的热程及咳嗽转归时间少于对照组,差异均有统计学意义(P<0.05);不同时间点观察组和对照组影像学恢复率比较,差异有统计学意义(P<0.05),观察组患儿白细胞总数恢复率为60.00%,明显高于对照组26.00%,差异有统计学意义(P<0.05)。结论电子支气管镜灌洗可以改善患儿缺氧情况,清除分泌物黏液阻塞,而对于心率无明显影响;且可以缩短咳嗽及发热病程;还可以促进病程早期胸部X线阴影吸收及白细胞总数的恢复。

OBJECTIVE To investigate the effect of electron bronchoscope on treatment of children with severe My- coplasma pneumonia and provide effective treatment, so as to provide a theoretical basis for its wide application. METHODS A total of 200 cases of children with severe M. pneumonia in the hospital from Oct. 2013 to Oct. 2015 were selected, and divided into observation group and control group. The control group only received the tradition- al methods of treatment, observation group were given conventional treatment, while the application of electronic hronchoscopy. The conventional and lavage specimens of two mycoplasma detection rate were analyzed and com- pared, clinical symptoms, laboratory examinations and other recovery were also compared. RESULTS In the course of treatment for patients with electronic bronchoscope, that over the glottis, the target site and SpO2 at the end of inspection changed significantly compared with those before inspection （P〈0.05）, while the HR did not change significantly. Taking lavage fluid as specimen, the M. pneumoniae positive rate was 41.00%, and the positive rate was 22.00% in conventional samples. The length of 5ever and vesting period of observation group were less than those of control group, and the difference was significant （P〈0. 05）. The imaging recovery rates of the two groups at different time points were significantly different （P〈0.05）. The total recovery rate of WBC of observa- tion group was 60.00%, which was significantly higher than 26.00% of control group （P〈0.05）. CONCLUSION Electronic bronchial lavage can improve children hypoxia, clear secretions mucus blockage, but had no significant effect on heart rate. Electronic bronchoscopy lavage treatment of children with severe pneumonia can shorten the duration of fever and cough, and can promote the early course of chest X-ray absorption and shadow WBC recovery.