纤维支气管镜灌洗治疗小儿重症肺炎的临床效果观察

Clinical Observation of Fiberoptic Bronchoscope Lavage in the Treatment of Severe Pneumonia in Children

目的:探讨纤维支气管镜灌洗治疗小儿重症肺炎的临床效果。方法:选取2020年1月~2021年4月收治的40例小儿重症肺炎患儿作为研究对象,用随机数字表法将其分对照组和观察组,各20例,对照组接受常规基础治疗,观察组接受纤维支气管炎镜灌洗治疗,比较两组患儿治疗疗效、康复用时、炎性指标等。结果:观察组治疗疗效高于对照组治疗疗效,差异有统计学意义(95%,65%,χ^(2)=5.6250,P<0.05),观察组机械通气时间、退热时间、感染控制时间短于对照组,差异有统计学意义(t=8.0212、3.1931、6.1100,P<0.05);两组患儿治疗前炎性指标比较,差异无统计学意义(tTNF-α=0.0961、tIL-6=0.0943、tCRP=0.0299、tPCT=0.0961,P>0.05);治疗后,观察组炎性指标低于对照组,差异有统计学意义(tTNF-α=5.6048、tIL-6=7.3761、tCRP=9.7784、tPCT=14.5247,P<0.05);两组患儿治疗前血气指标比较,差异无统计学意义(t二氧化碳分压=0.0299、t氧分压=0.0074,P>0.05);治疗后,观察组二氧化碳分压低于对照组,氧分压高于对照组,差异有统计学意义(t=4.2846、5.5965,P<0.05)。结论:在治疗小儿重症肺炎时,用纤维支气管镜灌洗取代常规肺泡灌洗,能缩短康复用时,更好地改善肺功能、炎性指标,提升疗效。

Objective:To investigate the clinical effect of fiberoptic bronchoscopy lavage in the treatment of severe pneumonia in children.Methods:40 children with severe pneumonia treated from January 2020 to April 2021 were selected as the research object.They were randomly divided into control group and observation group,with 20 cases in each group.The control group received routine basic treatment and the observation group received fiberoptic bronchitis mirror lavage treatment.The treatment efficacy,rehabilitation time,pulmonary function index and inflammatory index of the two groups were compared.Results:The therapeutic effect of the observation group was higher than the control group,the difference was statistically significant(95%,65%,χ^(2)=5.6250,P<0.05).The mechanical ventilation time,antipyretic time and infection control time of the observation group were shorter than those of the control group,the difference was statistically significant(t=8.0212,3.1931,6.1100,P<0.05);Comparison of inflammatory indexes between the two groups before treatment,the difference was not statistically significant(tTNF-α=0.0961,tIL-6=0.0943,tCRP=0.0299,tPCT=0.0961,P>0.05);After treatment,the inflammatory index of the observation group was lower than that of the control group,the difference was statistically significant(tTNF-α=5.6048,tIL-6=7.3761,tCRP=9.7784,tPCT=14.5247,P<0.05);There was no significant difference in blood gas indexes between the two groups before treatment(tPCO_(2)=0.0299,tPO_(2)=0.0074,P>0.05);After treatment,the partial pressure of carbon dioxide in the observation group was lower than that in the control group,and the partial pressure of oxygen was higher than that in the control group,the difference was statistically significant(t=4.2846,5.5965,P<0.05).Conclusion:In the treatment of severe pneumonia in children,the use of fiberoptic bronchoscope lavage instead of conventional alveolar lavage can shorten the time of Kang reuse,better improve pulmonary function and inflammatory indexes,and improve the curative effect.