支气管肺泡灌洗用于小儿重症肺炎的疗效及对患儿血清炎症因子水平的影响

Efficacy of bronchoalveolar lavage in children with severe pneumonia and its effect on serum inflammatory factor levels in children

目的探讨支气管肺泡灌洗用于小儿重症肺炎的疗效及对患儿血清炎症因子水平的影响。方法选取2019年1月至2021年1月该院收治的95例重症肺炎患儿为研究对象。将行支气管肺泡灌洗的50例患儿纳入研究组,未行支气管肺泡灌洗的45例患儿纳入对照组。比较两组患儿治疗后临床症状(包括发热、咳嗽、肺部湿啰音)消失时间及住院时间。比较两组治疗前、治疗7 d后的血气分析指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、二氧化碳分压(PaCO_(2))及氧合指数(PaO_(2)/FiO_(2))]及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平。比较两组不良反应发生情况及治疗效果。结果与对照组比较,研究组治疗后发热、咳嗽、肺部湿啰音消失时间更短,住院时间更短,差异有统计学意义(P<0.05)。治疗7 d后,两组PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平较治疗前升高,PaCO_(2)、血清TNF-α、IL-6、CRP水平均较治疗前下降,且研究组PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平高于对照组,PaCO_(2)、血清TNF-α、IL-6、CRP水平低于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率高于对照组,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)。结论在常规对症治疗的基础上联合支气管肺泡灌洗治疗小儿重症肺炎的效果较好,可有效改善患儿症状,降低炎症因子水平,促进肺功能恢复,且不会增加不良反应,安全性高。

Objective To investigate the efficacy of bronchoalveolar lavage in children with severe pneumonia and its effect on serum inflammatory factor levels in children.Methods A total of 95 children with severe pneumonia admitted to the hospital from January 2019 to January 2021 were selected as the research objects.Fifty children with bronchoalveolar lavage were included in the study group,and 45 children without bronchoalveolar lavage were included in the control group.The disappearance time of clinical symptoms(including fever,cough and pulmonary crackles)and hospitalization time were compared between the two groups after treatment.The blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2)),carbon dioxide partial pressure(PaCO_(2))and oxygenation index(PaO_(2)/FiO_(2))]and inflammation factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]levels were compared between the two groups before treatment and after 7 d of treatment.The incidence of adverse reactions and treatment effects were compared between the two groups.Results After treatment,compared with the control group,the disappearance time of fever,cough and pulmonary crackles in the study group was shorter,and the hospitalization time was shorter,the differences were statistically significant(P<0.05).After 7 d of treatment,PaO_(2),SaO_(2),PaO_(2)/FiO_(2) levels in the two groups increased compared with before treatment,PaCO_(2),serum TNF-α,IL-6 and CRP levels were decreased compared with before treatment,and PaO_(2),SaO_(2),PaO_(2)/FiO_(2) levels in the study group were higher than those in the control group,PaCO_(2),serum TNF-α,IL-6,CRP levels were lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Combining bronchoalveolar lavage on the basis of conventional symptomatic treatment has a good effect in the treatment of severe pneumonia in children,which could effectively improve the symptoms,reduce the level of inflammatory factor,and promote the recovery of lung function without increasing adverse reactions,with high safety.