支气管镜肺泡灌洗术治疗重症支原体肺炎患儿的效果

Effects of bronchoscopic alveolar lavage in treatment of children with severe mycoplasma pneumonia

目的:观察支气管镜肺泡灌洗术治疗重症支原体肺炎患儿的效果。方法:选取2019年5月至2020年6月该院收治的70例重症支原体肺炎患儿进行前瞻性研究,按照随机数字表法分为对照组和观察组各35例。对照组实施常规治疗,观察在对照组基础上实施支气管镜肺泡灌洗术治疗。比较两组临床疗效、临床症状消失时间和住院时间、治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]水平、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]水平及不良反应发生率。结果:观察组治疗总有效率为94.29%,高于对照组的74.29%,差异有统计学意义(P<0.05);观察组发热、咳嗽、肺啰音等临床症状消失时间和住院时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组FEV_(1)、FVC、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组PaO_(2)、PaO_(2)/FiO_(2)水平均高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:支气管镜肺泡灌洗术联合常规治疗应用于重症支原体肺炎患儿,可提高临床疗效,缩短临床症状消失时间和住院时间,提高肺功能,以及改善血气指标水平,其效果优于单纯常规治疗。

Objective:To observe effects of bronchoscopic alveolar lavage in treatment of children with severe mycoplasma pneumonia.Methods:70 children with severe mycoplasma pneumonia admitted to our hospital from May 2019 to June 2020 were selected for the prospective study,and were divided into control group and observation group according to the random number table method,35 cases in each group.The control group was given routine treatment,while the observation group was given bronchoscopic bronchoalveolar lavage on the basis of that of the control group.The clinical efficacy,the clinical symptom disappearance time,the hospitalization time,the lung function index levels[forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC],the blood gas indictor levels[arterial oxygen partial pressure(PaO_(2)),arterial blood carbon dioxide partial pressure(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2))],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 94.29%,which was higher than 74.29%of the control group,and the difference was statistically significant(P<0.05).The disappearance time of fever,cough,lung rales and other clinical symptoms and the stay time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of FEV_(1),FVC,and FEV_(1)/FVC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of PaO_(2) and PaO_(2)/FiO_(2) in the observation group were higher than those in the control group;the level of PaCO_(2) was lower than that in the control group;and the differences were statistically significant(P<0.05).However,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Bronchoscopic alveolar lavage combined with routine treatment for the children with severe mycoplasma pneumonia can improve the clinical efficacy,shorten the symptom disappearance time and the hospitalization time,improve the lung function,and the improve blood gas indcator levels.Moreover,it is superior to single routine treatment.