肺泡灌洗治疗肺炎支原体肺炎患儿的效果分析

Analysis on the effect of electronic bronchoscopy lavage in the treatment of children with Mycoplasma pneumoniae pneumonia

目的探究电子支气管镜灌洗术在不同发热病程肺炎支原体肺炎患儿中的治疗效果。方法选择行电子支气管镜灌洗术的肺炎支原体肺炎患儿110例,根据发热病程分为早期(发热病程<7 d,43例)、中期(发热病程为7~14 d,38例)及晚期灌洗组(发热病程为15~30 d,29例),另选择采用常规方式治疗的患儿45例为对照组。入组后7 d,评定患儿临床疗效;各组均于术前、出院时测量肺功能指标最高呼气流量(PEF),用力肺活量(FVC)水平;观察临床症状、体温恢复时间及咳嗽、抗生素、啰音时间及住院时间;评估安全性。结果电子支气管镜灌洗术治疗不同发热病程总有效率高于对照组(P<0.05);与对照组比较,早期、中期、晚期灌洗组症状体征恢复或消失时间均减少(P<0.05);与早期、晚期灌洗组比较,中期灌洗组症状体征消失时间均减少(P<0.05);与对照组比较,早期、中期、晚期灌洗组PEF、FVC水平均升高(P<0.05);与早期、晚期灌洗组比较,中期灌洗组PEF、FVC水平均减少(P<0.05);4组不良反应发生情况无显著差异(P>0.05)。结论电子支气管灌洗术治疗肺炎支原体肺炎具有一定安全性,在发热病程7~14 d时应用最佳。

Objective To explore the therapeutic effect of electronic bronchoscopy lavage in the treatment of children with Mycoplasma pneumoniae pneumonia in their different fever stages.Methods A total of 110 children with Mycoplasma pneumoniae pneumonia undergoing electronic bronchoscopy lavage were selected and divided into early(with a fever course<7 days,43 cases),middle(with a fever course of 7-14 days,38 cases)and late(with a fever course of 15 to 30 days,29 cases)lavage groups,according to the different courses of fever,and 45 children treated with a conventional treatment were selected as the control group.Seven days after the enrollment,the clinical efficacy of the children was evaluated,and the pulmonary function indexes,the peak expiratory flow(PEF)and forced vital capacity(FVC)levels were measured before operation and at discharge in each group,while the clinical symptoms,temperature recovery time,cough,antibiotics,rale time and hospital stay were observed,and the treatment safety was evaluated.Results The total effective rate of the electronic bronchoscopy lavage in the treatment of Mycoplasma pneumoniae pneumonia in different fever stages was higher than that in the control group(P<0.05).Compared with the control group,the recovery or disappearance time of symptoms and signs in the early,middle and late lavage groups were all decreased(P<0.05).Compared with the early and late lavage groups,the disappearance time of symptoms and signs in the middle lavage group was decreased(P<0.05).Compared with the control group,the levels of PEF and FVC in the early,middle and late lavage groups were all increased(P<0.05).Compared with the early and late lavage groups,the levels of PEF and FVC in the middle lavage group were both decreased(P<0.05).There was no significant difference in the occurrence of adverse reactions among the four groups(P>0.05).Conclusion Electronic bronchial lavage is safe in the treatment of Mycoplasma pneumoniae pneumonia,and the best time to apply it is when the course of fever is 7 to 14 days.