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临床应用价值

Clinical application value of bronchoalveolar lavage in diagnosis and treatment of children with refractory mycoplasma pneumoniae pneumonia

目的:探究支气管肺泡灌洗术在儿童难治性肺炎支原体肺炎(RMPP)临床诊治中的作用。方法:将我院收诊的80例RMPP患儿纳入研究,其中40例行支气管肺泡灌洗术治疗的为观察组,另40例未行支气管肺泡灌洗术治疗的为对照组,观察RMPP镜下形态学特点,并比较两组患儿的预后转归情况。结果:(1)RMPP镜下形态学特点:镜下可见黏膜充血肿胀,黏液性分泌物增多,叶或段管壁炎性狭窄有纵行皱褶、有小结节样突起,黏膜糜烂、剥脱和形成痰栓,段支气管通气不良。(2)RMPP预后转归情况:观察组的治疗有效率明显高于对照组,且观察组的总热程、咳嗽消失时间,肺部体征消失时间及住院时间明显短于对照组(P<0.01)。结论:支气管肺泡灌洗术可对儿童RMPP诊治提供帮助,对于改善患儿近期预后转归有重要意义。

Objective： To explore the role of bronchoalveolar lavage in the diagnosis and treatment of children with refractory mycoplasma pneumoniae pneumonia（RMPP）. Methods： 80 cases of children with RMPP treated in our hospital were included in the study,and 40 cases in the observation were treated with bronchoalveolar lavage,while another 40 cases in the control group were not treated with bronchoalveolar lavage. Then,the morphological characteristics of RMPP were observed,and the prognosis and outcomes of children in both groups were compared. Results：（1）The morphological characteristics under the RMPP microscope： The mucous congestion and swelling of mucous membrane were observed under the microscope, and the mucous secretions increased. There were longitudinal folds, small nodular protuberances,mucous erosion,exfoliation and formation of phlegm suppositories the bronchial lobe or segment wall,and bad bronchoalveolar ventilation.（2） RMPP prognosis and outcomes： The effective rate in the observation group was significantly higher than that in the control group,and the total course of treatment,cough disappear time,the disappearance time of pulmonary signs and hospital stay in the observation group were significantly shorter than those in the control group（P〈0. 01）. Conclusion： The bronchoalveolar lavage can provide help for the diagnosis and treatment of children with RMPP,and it has great significance for improving the prognosis and outcomes of children with RMPP.