纤维支气管镜肺泡灌洗治疗新生儿重症肺炎的临床效果

Clinical effect of alveolar lavage with fiberoptic bronchoscope for severe neonatal pneumonia

目的探讨纤维支气管镜肺泡灌洗(BAL)治疗新生儿重症肺炎的临床效果。方法选取2015年11月~2017年1月嘉兴市妇幼保健院收治的重症肺炎新生儿80例,根据是否采用BAL治疗分为观察组(40例)和对照组(40例)。两组均给予抗炎、吸氧、增强免疫等基础治疗措施,观察组同时采取BAL治疗。比较两组患儿临床症状缓解时间、治疗前后血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血乳酸水平及临床效果。结果观察组患儿的发绀消失时间、呼吸困难缓解时间、心率恢复时间、肺部啰音消失时间、ICU住院时间均显著的短于对照组,差异有统计学意义(P <0.05)。治疗前,两组的血清IL-2、IL-6、IL-10水平差异无统计学意义(P> 0.05);治疗后,观察组患儿的血清IL-6、IL-10水平低于对照组,IL-2水平高于对照组,差异有统计学意义(P <0.05)。治疗前,两组的PaO2、PaCO2、血乳酸水平水平差异无统计学意义(P> 0.05);治疗后,观察组患儿的PaCO2、血乳酸水平低于对照组,PaO2水平高于对照组,差异有统计学意义(P <0.05)。治疗7 d后,观察组临床疗效优于对照组,差异有统计学意义(P <0.05)。结论 BAL结合基础治疗对新生儿重症肺炎具有更显著的治疗效果。

Objective To investigate the clinical effect of bronchoalveolar lavage(BAL)in the treatment of neonatal severe pneumonia.Methods From November 2015 to January 2017,in Jiaxing Maternal and Child Health Hospital,80 children with severe pneumonia neonates were selected,according to whether or not BAL treatment,they were divided into observation group(40 cases)and control group(40 cases).Both groups were given basic treatment measures such as anti-inflammation,oxygen inhalation,and immunity enhancement,the observation group was treated with BAL at the same time.The clinical symptom remission time,serum interleukin-2(IL-2),interleukin-6(IL-6),and interleukin-10(IL-10),arterial oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2),blood lactate levels before and after treatment and clinical efficacy were compared between the two groups.Results The disappearance of cyanosis,dyspnea remission time,heart rate recovery time,disappearance of pulmonary rales and hospital stay in ICU in the observation group were significantly shorter than in the control group,the differences were statistically significant(P<0.05).Before treatment,the levels of serum IL-2,IL-6 and IL-10 were compared,the differences were not statistically significant(P>0.05);after treatment,the levels of serum IL-6 and IL-10 in the observation group were lower than the control group,the level of IL-2 was higher than the control group,the differences were statistically significant(P<0.05).Before treatment,the levels of PaO2,PaCO2,and blood lactic acid in the two groups were compared,the differences were not statistically significant(P>0.05);after treatment,the levels of PaCO2,lactic acid in the observation group were lower than the control group,and the level of PaO2 was higher than the control group,the differences were statistically significant(P<0.05).After 7 days of treatment,the clinical efficacy of the observation group was better than the control group,the difference was statistically significant(P<0.05).Conclusion BAL combined with basic treatment has a more significant therapeutic effect on neonatal severe pneumonia.