支气管肺泡灌洗治疗儿童大叶性肺炎分析

Analysis of Children with Lobar Pneumonia Treated by Bronchoalveolar Lavage

目的:探讨支气管肺泡灌洗(Bronchoalveolar lavage,BAL)在儿童大叶性肺炎诊治中的临床应用价值。方法:将郴州市第一人民医院儿童呼吸科2014年1月-2015年12月期间收治的78例大叶性肺炎患儿作为研究对象,分为实验组(n=46)与对照组(n=32),对照组接受儿童呼吸内科常规治疗,包括抗感染、雾化、化痰等治疗;实验组在常规治疗基础上另外辅以支气管镜肺泡灌洗治疗。观察两组症状改善情况、肺部啰音消散情况、炎症指标变化、肺部CT改变、住院时间及费用、病原学检出率等。结果:两组间发热、咳嗽、呼吸困难、肺部啰音、肺不张、肺实变、肺气肿、胸腔积液及白细胞、C反应蛋白、降钙素原水平的差异无统计学意义(P>0.05)。治疗后,实验组症状改善情况、肺部啰音消散情况、炎症指标变化、肺部CT改变、住院时间及费用、细菌检出率均优于对照组,差异具有统计学意义(P<0.05)。结论:支气管镜肺泡灌洗治疗儿童大叶性肺炎有利于临床症状的缓解及肺部炎症的吸收,可改善肺部影像学,促进疾病恢复,减少住院时间和费用。

Objective：To investigate the clinical application value and the curative effect of bronchoalveolar lavage（BAL）in the diagnosis and treatment of lobar pneumonia in children.Methods：78children with lobar pneumonia were enrolled from department of pediatric respiration at the First Hospital of Chenzhou from January 2014 to December2015.The enrolled infants were divided into experimental group（n=46）and control group（n=32）.Patients in the control group were received conventional treatment,including anti-infective therapy,atomization,resolve phlegm and other treatment;the experimental group were received the conventional treatment and supplemented by fiber bronchoscopy alveolar lavage treatment.The therapeutic effects were observed on the two groups,including the improvement of symptoms,lung rale,inflammatory biomarkers,lung CT,the duration of hospital stays and hospital costs,pathogen detection rate and so on.Results：There have no significant differences of fever,cough,dyspnea,lung rales,atelectasis,pulmonary consolidation,emphysema,pleural effusion and white blood cell（WBC）,C-reactive protein（CRP）and procalcitonin（PCT）level between the two groups（P〈0.05）.Comparing with control group,there was statistically significant differences in the experimental group of the changes of symptoms,the changes of lung rales,the changes of inflammatory indexes,the changes of lung CT,the time and cost of hospitalization and the detection rate of bacteria（P〉0.05）.Conclusion：Using Bronchoalveolar lavage to treat children with lobar pneumonia can improve the clinical symptoms and the absorption of lung inflammation,improve the lung imaging,promote the recovery of the disease,shorten the time of hospital stay,decrease the cost of hospitalization.