纤维支气管镜肺泡灌洗联合丙种球蛋白治疗小儿重症肺炎的疗效及对炎症因子的影响

Therapeutic Effect of Bronchoalveolar Lavage Combined with Gamma Globulin on Severe Pneumonia in Children and its Influence on Inflammatory Factors

目的探讨纤维支气管镜肺泡灌洗联合丙种球蛋白治疗小儿重症肺炎的临床疗效及对炎症因子的影响。方法选取2018年10月~2021年11月我院收治的患重症肺炎儿童60例,随机分为对照组与联合治疗组,各30例。对照组予以丙种球蛋白治疗,联合治疗组予以纤维支气管镜肺泡灌洗联合丙种球蛋白治疗,比较两组临床疗效、临床症状改善情况、治疗前后肺部感染评分(CPIS)和APACHEⅡ评分、血清炎性因子水平[C反应蛋白(CRP)、白介素6(IL-6)、前降钙素(PCT)水平、白细胞计数(WBC)]。结果联合治疗组总有效率为93.33%,高于对照组的63.33%(P<0.05);联合治疗组咳嗽消失时间、肺啰音消失时间、体温恢复时间、血气指标改善时间短于对照组(P<0.05);联合治疗组CPIS和APACHEⅡ评分均低于对照组(P<0.05);联合治疗组CRP、IL-6、WBC、PCT水平低于对照组(P<0.05)。结论纤维支气管镜肺泡灌洗联合丙种球蛋白治疗小儿重症肺炎具有良好的临床疗效,可有效改善患儿临床症状,减少病原菌增生环境,抑制病原菌增生和机体炎症反应。

Objective To investigate the clinical efficacy of bronchoalveolar lavage combined with gamma globulin in the treatment of severe pneumonia in children and its effect on inflammatory factors.Methods Sixty children with severe pneumonia admitted to our hospital from October 2018 to November 2021 were randomly divided into control group and combined treatment group,with 30 cases in each group.The control group was treated with gamma globulin,and the combined treatment group was treated with bronchoalveolar lavage combined with gamma globulin.The clinical efficacy,improvement of clinical symptoms,pulmonary infection score(CPIS)and APACHEⅡscore before and after treatment,serum inflammatory factor levels[C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)level,white blood cell count(WBC)]were compared between the two groups.Results The total effective rate of the combined treatment group was 93.33%,which was higher than 63.33%of the control group(P<0.05).The cough disappearance time,lung rale disappearance time,body temperature recovery time and blood gas index improvement time in the combined treatment group were shorter than those in the control group(P<0.05).The CPIS and APACHEⅡscores in the combined treatment group were lower than those in the control group(P<0.05).The levels of CRP,IL-6,WBC and PCT in the combined treatment group were lower than those in the control group(P<0.05).Conclusion Bronchoscopic alveolar lavage combined with gamma globulin has a good clinical effect on severe pneumonia in children,which can reduce the infection and inflammatory reaction of children.