早期纤支镜肺泡灌洗术对重症肺炎合并肺不张患儿血气指标及胸片恢复情况的影响

Effects of Early Bronchoalveolar Lavage with Fiberoptic Bronchoscopy on Blood Gas Indexesand Chest X-Ray Recovery in Children with Severe Pneumonia Complicated with Atelectasis

目的分析早期纤支镜肺泡灌洗术对重症肺炎合并肺不张患儿血气指标及胸片恢复情况的影响。方法回顾性选取东莞市儿童医院2019年1月—2021年1月收治的重症肺炎合并肺不张患儿60例,根据治疗方式的不同分为对照组(23例)和观察组(37例)。对照组给予有创机械通气常规治疗,观察组在以上基础给予纤支镜肺泡灌洗术治疗。比较两组患者临床治疗效果,并观察血气指标的变化及胸片恢复情况。结果观察组临床总有效率91.89%高于对照组69.57%,差异有统计学意义(χ^(2)=5.091,P<0.05);观察组肺复张时间、呼吸纠正时间、住院时间均明显短于对照组,血氧饱和度(SpO_(2))、血氧分压(PaO_(2))均明显高于对照组,差异有统计学意义(P<0.05);经治疗后观察组胸片恢复情况显著优于对照组,差异有统计学意义(P<0.05)。结论早期纤支镜肺泡灌洗术对重症肺炎合并肺不张患儿给予纤支镜肺泡灌洗术治疗不仅能减轻患儿病情,调节血气指标,还能促进影像学恢复,显著提升临床效果。

Objective To analyze the effect of early bronchoalveolar lavage with fiberoptic bronchoscopy on blood gas indexes and chest X-ray recovery in children with severe pneumonia complicated with atelectasis.Methods A retrospective selection of 60 children with severe pneumonia and atelectasis admitted to Dongguan Children's Hospital from January 2019 to January 2021.According to different treatment methods,they were divided into control group(23 cases)and observation group(37 cases).The control group was given conventional treatment with invasive mechanical ventilation,and the observation group was given bronchoscopic bronchoalveolar lavage on the basis of the above.The clinical treatment effects of the two groups were compared,and the changes of blood gas indexes and the recovery of chest X-ray were observed.Results The total clinical effective rate of the observation group was 91.89% higher than that of the control group 69.57%,and the difference was statistically significant(χ^(2)=5.091,P<0.05);the lung recruitment time,respiration correction time,and hospital stay in the observation group were significantly shorter than those in the control group,and the blood oxygen saturation(SpO_(2))and blood oxygen partial pressure(PaO_(2))were significantly higher than those in the control group,and the differences were statistically significant(P<0.05);after treatment,the recovery of chest X-ray in the observation group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Early bronchoscopic bronchoalveolar lavage for children with severe pneumonia complicated with atelectasis treated with bronchoscopic bronchoalveolar lavage can not only alleviate the children's condition,regulate blood gas indexes,but also promote the recovery of imaging,significantly improve the clinical effect.