t-PA对儿童塑型性支气管炎症状改善情况及血氧状态的影响

Effect of t-PA on Symptom Improvement and Blood Oxygenation in Children with Plastic Bronchitis

目的探讨在儿童塑型性支气管炎(CB)治疗中组织型纤溶酶原激活剂(t-PA)对症状的改善情况及血氧状态的影响。方法采用随机数表法将60例儿童CB患者分为A、B 2组,每组各30例。2组均行纤支镜手术,B组在此基础上加用重组t-PA。比较治疗前后炎症指标水平[白细胞(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)],观察治疗后2组的疗效[手术有效率、1周后血氧饱和度(SpO_2)、体温恢复正常时间]、住院时间及复发率的差异。结果 (1)B组的手术有效率及1周后SpO_2水平均高于A组(P<0.05),住院时间、体温恢复正常时间则短于A组(P<0.05);(2)2组WBC、CRP、IL-6指标水平均较治疗前降低,B组降幅大于A组(P<0.05);(3)B组随访6个月复发率比A组低(P<0.05)。结论较单用纤支镜手术,常规治疗联合t-PA方案治疗儿童CB的疗效更显著,能有效改善患儿缺氧状况,于其病情转归有利。

Objective To investigate the effect of tissue-type plasminogen activator（t-PA） on symptom improvement and blood oxygenation in children with plastic bronchitis plastic bronchitis（CB）. Methods 60 CB children admitted in our hospital were randomly divided into group A（30 cases） and group B（30 cases）. Both groups were operated by fiberoptic bronchoscopy to remove foreign bodies, besides, the group B was perfused with recombinant t-PA into blocked bronchi. The inflammatory indexes before and after the treatment [white blood cell（WBC）, C reactive protein（CRP） and interleukin-6（IL-6）] were compared, and the curative effects [effective rate of operation, blood oxygen saturation（SpO2） after a week, body temperature recovery time, hospitalization time and recurrence rates after treatment in the two groups were observed. Results The effective rate of operation and SpO2 level in the group B were all higher than those in the group A（P〈0.05） after a week, the hospitalization time and body temperature recovery time in the group B were all shorter than those in the group A（P〈0.05）, after treatment, the WBC, CRP and IL-6 levels in the two groups were decreased, and the decrease in the group B was higher than that in the group A（P〈0.05）, after 6 months follow-up, the recurrence rate in the group B was lower than that in the group A（P〈0.05）. ConclusionCompared with single fiberoptic bronchoscopy surgery, conventional treatment combined with t-PA regimen which is more effective and favorable for the prognosis of disease, can effectively improve the status of hypoxia in children with CB.