支气管镜肺泡灌洗术在难治性支原体肺炎治疗中的疗效与炎症标志物变化

The Effect of Bronchoscopic Alveolar Lavage on the Treatment of Refractory Mycoplasma Pneumonia and the Changes of Inflammatory Markers

目的:回顾分析支气管镜肺泡灌洗术在治疗难治性支原体肺炎(RMPP)中的疗效与外周血炎症标志物变化,为RMPP的合理治疗提供依据。方法:选取2017年1月至2020年1月南方医科大学附属小榄医院住院的61例确诊为RMPP患儿,其中31例(对照组)给予大环内酯类抗菌药物抗感染、甲基泼尼松龙免疫调控等常规治疗,30例(观察组)在常规治疗基础上行支气管镜肺泡灌洗术,回顾性分析两组患儿的临床资料差异,包括年龄、性别、入院后发热天数、肺部阳性体征消失时间、外周血白细胞、血C反应蛋白(CRP)、降钙素原(PCT)、D-二聚体、肺部影像学吸收时间、住院天数等。结果:观察组入院后发热天数、肺部阳性体征消失时间、肺部影像学吸收时间及住院天数较对照组缩短,差异具有统计学意义(P<0.05)。观察组治疗有效率明显高于对照组,差异具有统计学意义(P<0.05);支气管镜肺泡灌洗术治疗后的观察组患儿血CRP、PCT、D-二聚体较对照组明显下降,差异具有统计学意义(P<0.05)。结论:支气管肺泡灌洗术对RMPP患儿的治疗效果显著,在减轻RMPP患儿的炎症指标方面有明显帮助。

Objective To retrospectively analyze the efficacy of bronchoscopic alveolar lavage in the treatment of refractory mycoplasma pneumoniae pneumonia(RMPP)and changes in peripheral blood inflammation markers,in order to provide a basis for the rational treatment of RMPP.Methods A total of 61 children who were diagnosed with RMPP in our hospital from January 2017 to January 2020 were hospitalized.Of these,31(control group)were given macrolide antibiotics against infection and methylprednisolone for immunoregulation and other conventional treatments,30 patients(treatment group)underwent bronchoscopic alveolar lavage on the basis of conventional treatment,and retrospectively analyzed clinical data of children in both groups,including age,gender,fever days after admission,and positive lungs sign disappearance time,peripheral white blood cells,peripheral blood C-reactive protein(CRP),procalcitonin(PCT),D-dimer,pulmonary imaging absorption time,length of hospital stay,etc.Results After fever days admission,the disappearance of lung positive signs,the time of pulmonary imaging absorption and the length of hospital stay in the treatment group were shorter than those in the control group after admission,the differences were statistically significant(P<0.05).Therapeutic effect of treatment group was significantly higher than the control group,and the difference between the two groups was statistically significant(P<0.05).CRP,PCT and D-dimer in the treatment group after the treatment of bronchoscopic alveolar lavage were significantly lower than those in the control group.and the difference between the two groups was statistically significant(P<0.05).Conclusions Bronchoalveolar lavage is effective in treating children with refractory mycoplasma pneumoniae pneumonia;the treatment of Bronchoscope alveolar lavage is helpful for children with RMPP in reducing inflammation.