支气管肺泡灌洗术在儿童难治性肺炎支原体肺炎诊治中的作用

The Role of Bronchoalveolar Lavage in the Diagnosis and Treatment of Children with Refractory Mycoplasma Pneumoniae Pneumonia

目的探讨支气管肺泡灌洗术在儿童难治性肺炎支原体肺炎治疗中的价值。方法回顾性分析行支气管肺泡灌洗的146例RMPP患儿的临床资料。结果 146例患儿共进行了163例次支气管肺泡灌洗术。病变部位以内膜炎症为主要表现,支气管开口粘稠分泌物阻塞56例(38.4%),管腔内粘液栓形成24例(16.4%),粘膜皱襞48例(32.9%),肉芽阻塞支气管开口2例(1.4%),塑型性支气管炎3例(2.1%)。经支气管肺泡灌洗治疗后,1周完全肺复张113例(77.4%),2周完全肺复张24例(16.4%),4周完全肺复张8例(5.5%),6周完全肺复张1例(0.7%)。103例对照组患儿1周完全肺复张34例(33%),2周完全肺复张22例(21.4%),4周完全肺复张38例(36.9%),6周完全肺复张6例(5.8%),8周时还有3例肺未完全复张(2.9%)。结论支气管肺泡灌洗术在RMPP的诊治中具有较高的应用价值,应早期进行支气管肺泡灌洗治疗,缩短病程,促进肺复张,减少肺部后遗症的发生。

Objective To explore the value of bronchoalveolar lavage in the treatment of children with refractory mycoplasma pneumoniae pneumonia. Methods The clinical data of 146 cases of RMPP in children with bronchial alveolar lavage were analyzed retrospectively.Results A total of 146 patients of bronchial alveolar lavage were done in 163 cases. The lesions in endometrial inflammation were the main manifestations,56 cases of bronchial opening viscous secretion obstruction（ 38. 4%）,24 casesof intraluminal mucus plug formation（ 16. 4%）,48 cases of mucosal folds（ 32. 9%）,2 cases of obstructive granulation bronchus（ 1. 4%）,3 cases of plastic bronchitis（ 2. 1%）. After bronchoalveolar lavage treatment,113 cases of complete pulmonary rehabilitation in 1 week（ 77. 4%）,24 cases of complete pulmonary rehabilitation in 2 weeks（ 16. 4%）,8 cases of complete pulmonary rehabilitation in 4 weeks（ 5. 5%）,and 1 case of complete pulmonary rehabilitation in 6 weeks（ 0. 7%）. In 103 patients of control group,34 cases of complete pulmonary rehabilitation in 1week（ 33%）,22 cases of complete pulmonary rehabilitation in 2 weeks（ 21. 4%）,38 cases of complete pulmonary rehabilitation in 4 weeks（ 36. 9%）,6 cases of complete pulmonary rehabilitation in 6weeks（ 2. 9%）.And at 8 weeks,there were 3 patients with incomplete lung recruitment in control group（ 2. 9%）. Conclusion Bronchoalveolar lavage in the diagnosis and treatment of RMPP has a high value of application. RMPP patients should be treated with early bronchial alveolar lavage,in order to shorten the course of disease,promote pulmonary rehabilitation,and reduce the incidence of pulmonary sequelae.