纤维支气管镜肺泡灌洗治疗肺炎患儿的临床分析

Clinical Analysis of 100 Children with Pneumonia Treated by Bronchofibroscope Alveolar Lavage

目的:探讨行纤维支气管镜肺泡灌洗治疗肺炎患儿的病原学及灌洗部位特点。方法:选取2018年2月-2019年3月常州市第一人民医院收治的100例行纤维支气管镜肺泡灌洗治疗的肺炎患儿作为研究对象,按年龄分为学龄前组和学龄期组。两组均采取纤维支气管镜肺泡灌洗治疗。比较两组好转率、不良反应发生情况、病原学及灌洗部位的特点。结果:两组患儿均好转出院,无严重不良反应发生。100例患儿中病原阳性率为61%,其中肺炎支原体占59%。学龄前组和学龄期组肺炎支原体检出分别为31例(67%)、28例(52%),差异无统计学意义(P>0.05)。肺泡灌洗部位数量前5位的分别是左肺下叶前内基底段52例(52%),右肺下叶前基底段45例(45%),右肺下叶外侧基底段45例(45%),左肺下叶外侧基底段43例(43%),右肺中叶内侧段41例(41%)。两组灌洗部位比较,差异无统计学意义(P>0.05)。结论:纤维支气管镜检查伴肺泡灌洗对儿童重症肺炎或经验治疗效果不佳的患儿疗效较好,安全性高,值得临床应用并予以推广。

Objective:To explore the etiology and lavage site characteristics of children with pneumonia who were treated with bronchofibroscope alveolar lavage.Methods:A total of 100 children with pneumonia treated by bronchofibroscope alveolar lavage in Changzhou First People's Hospital were selected as the study subjects,and they were divided into preschool group and schoolage group according to the age.The improvement rate,occurrence of adverse reactions,etiology and lavage site characteristics were compared between the two groups.Results:All the 100 children were improved and discharged without serious adverse reactions.The positive rate of pathogens in 100 selected cases was 61%,and Mycoplasma pneumoniae accounted for 59%.The detection rates of Mycoplasma pneumoniae in two groups were 31 cases(67%)and 28 cases(52%),respectively,and there was no statistically significant difference between the two groups(P>0.05).The top five sites of alveolar lavage were the anteromedial basal segment of the left lung inferior lobe in 52 cases(52%),the anterior basal segment of the right lung inferior lobe in 45 cases(45%),the lateral basal segment of the right lung inferior lobe in 45 cases(45%),the lateral basal segment of the left lung inferior lobe in 43 cases(43%),and the medial segment of the right lung middle lobe in 41 cases(41%).There was no significant difference in pulmonary inflammatory at lavage sites between the two groups(P>0.05).Conclusion:For severe pneumonia children or children with poor response to empirical treatment,bronchofibroscope alveolar lavage has good efficacy and high safety,and deserves clinical application and promotion.