不同年龄段难治性肺炎支原体肺炎急性期患儿纤维支气管镜下气道改变特点

The characteristics of airway changes under fiber bronchoscope in refractory Mycoplasma pneumoniae pneumonia children during acute phase in different age groups

目的了解不同年龄段难治性肺炎支原体肺炎(RMPP)急性期患儿纤维支气管镜下气道改变特点。方法选取2015年1月-2016年1月在郑州大学第三附属医院确诊为RMPP的住院患儿65例,详细记录患儿的临床资料,并进行统计分析。将所有入选患儿按年龄分为婴幼儿组(<3岁)15例、学龄前儿童组(3~6岁)24例、学龄儿童组(6~15岁)26例。比较不同年龄段儿童RMPP的纤维支气管镜下气道改变的差异。结果婴幼儿组、学龄前儿童组、学龄儿童组急性期气道黏膜充血肿胀、纵行皱褶、分泌物增多、叶或段支气管开口炎性狭窄、管腔软化发生率比较差异无统计学意义(P>0.05);婴幼儿组、学龄前儿童组、学龄儿童组气道黏液栓阻塞发生率比较差异有统计学意义(P<0.05),学龄儿童组、学龄前儿童组的发生率较婴幼儿组显著增高;3组管腔闭塞、管腔肉芽组织增生、黏膜糜烂发生率较低,差异无统计学意义(P>0.05)。结论不同年龄段RMPP急性期儿童纤维支气管镜下气道改变不同,尤其婴幼儿与学龄期儿童之间的差异更明显。

Objective To understand the characteristics of airway changes under fiber bronchoscope in refractory Mycoplasma pneumoniae pneumonia（ RMPP） children during acute phase in different age groups.Methods Sixty-five children diagnosed as RMPP definitely in the hospital from January 2015 to January 2016 were selected,the clinical data of these children was recorded in detail and analyzed statistically.The children were divided into infant group（ 3 years,15 children）,preschool-age child group（ ≥3 years,24 children）,school-age child group（ 6-15 years,26 children）.The differences of airway changes under fiber bronchoscope in the three groups were compared.Results There was no statistically significant difference in airway mucosal hyperemia and swelling,longitudinal folds,secretion increase,inflammatory bronchial stenosis and lumen softening among the three groups（ P〉0.05）; there was statistically significant difference in the incidence rate of airway mucous plug block among the three groups（ P〈0.05）,the incidence rates in preschool-age child group and school-age child group were significantly higher than that in infant group; the incidence rates of lumen occlusion,lumen granulation tissue proliferation and mucosa erosion in the three groups were low,and there was no statistically significant difference among the three groups（ P〉0.05）.Conclusion The changes of airway under fiber bronchoscope in RMPP children during acute phase in different age groups are different,the difference between infants and school-aged children is more obvious.