观察PICU重症肺炎患儿行床旁纤维支气管镜治疗的临床效果

Observation on the clinical effect of bedside fiber bronchoscope in treatment of children with severe pneumonia in PICU

目的观察儿科重症监护病房(PICU)重症肺炎患儿行床旁纤维支气管镜治疗的临床效果。方法对2015年4月-2017年4月该院收治的80例重症肺炎患儿的临床资料进行统计分析,依据治疗方法将这些患儿分为常规治疗组和常规治疗联合床旁纤维支气管镜灌洗治疗组(联合治疗组),每组各40例。对两组患儿的临床疗效、体温、咳嗽、喘息恢复正常时间、肺部啰音消失时间及住院时间、痰液显著减少或消失时间、痰培养转阴时间、机械通气时间、肺部病变吸收一半以上时间及外周血白细胞计数、并发症发生情况进行统计分析。结果联合治疗组患儿治疗的总有效率为85.0%(34/40),显著高于常规治疗组的62.5%(25/40)(P<0.05),体温、咳嗽、喘息恢复正常时间、肺部啰音消失时间及住院时间均显著短于常规治疗组(P<0.05),痰液显著减少或消失时间、痰培养转阴时间、机械通气时间、肺部病变吸收一半以上时间均显著短于常规治疗组(P<0.05),外周血白细胞计数显著低于常规治疗组(P<0.05),并发症发生率为7.5%(3/40),显著低于常规治疗组的22.5%(9/40)(P<0.05)。结论 PICU重症肺炎患儿行床旁纤维支气管镜治疗的临床效果好,值得在临床推广。

Objective To observe the clinical effect of bedside fiber bronchoscope in treatment of children with severe pneumonia in PICU. Methods The clinical data of 80 children with severe pneumonia treated in Kunming Children＇s Hospital from April 2015 to April2017 was statistically analyzed,then these children were divided into conventional treatment group and combined treatment group（ conventional treatment combined with bedside fiber bronchoscope）,40 patients in each group. The clinical effects,recovery time of temperature,coughing and wheezing,disappearance time of lung rales,hospitalization time,significant decrease or disappearance time of sputum,negative conversion time of sputum culture,mechanical ventilation time,the time for absorption of more than half lung lesions,white blood cell count in peripheral blood,and complications in the two groups were statistically analyzed. Results The total effective rate in combined treatment group was 85. 0%（ 34/40）,which was statistically significantly higher than that in conventional treatment group（ 62. 5%,25/40）（ P〈0. 05）. The recovery time of temperature,coughing and wheezing,disappearance time of lung rales,and hospitalization time in combined treatment group were statistically significantly shorter than those in conventional treatment group（ P〈0. 05）. The significant decrease or disappearance time of sputum,negative conversion time of sputum culture,mechanical ventilation time,and the time for absorption of more than half lung lesions in combined treatment group were statistically significantly shorter than those in conventional treatment group（ P〈0. 05）. White blood cell count in peripheral blood in combined treatment group was statistically significantly lower than that in conventional treatment group（ P〈0. 05）. The incidence rate of complications in combined treatment group was 7. 5%（ 3/40）,which was statistically significantly lower than that in conventional treatment group（ 22. 5%,9/40）（ P〈0. 05）. Conclusion The clinical effect of bedside fiber bronchoscope in treatment of children with severe pneumonia in PICU is good,which is worthy of clinical promotion.