支气管肺泡灌洗术联合阿奇霉素治疗儿童难治性肺炎支原体肺炎的疗效分析

Efficacy analysis of bronchoalveolar lavage combined with azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia in children

目的探讨支气管肺泡灌洗术联合阿奇霉素治疗儿童难治性肺炎支原体肺炎(RMPP)的临床价值。方法90例儿童RMPP患儿为研究对象,依据治疗方式不同分为A组(27例)、B组(25例)和C组(38例)。A组口服阿奇霉素干混悬剂治疗,B组静脉滴注阿奇霉素联合支气管肺泡灌洗术治疗,C组口服阿奇霉素干混悬剂联合支气管肺泡灌洗术治疗。比较三组临床疗效、临床指标恢复正常时间及不良反应发生情况。结果C组治疗总有效率与B组比较,差异无统计学意义(P>0.05)。C组、B组治疗总有效率分别为96.00%、94.74%,均高于A组的59.26%,差异均有统计学意义(P<0.05)。C组咳嗽、胸片、体温、C反应蛋白恢复正常时间与B组比较,差异无统计学意义(P>0.05)。C组咳嗽、胸片、体温、C反应蛋白恢复正常时间分别为(11.29±2.49)、(10.69±1.36)、(11.26±3.13)、(10.17±1.29)d,B组咳嗽、胸片、体温、C反应蛋白恢复正常时间分别为(11.11±2.12)、(10.65±1.39)、(11.25±3.15)、(10.19±1.33)d,均短于A组的(14.25±3.26)、(13.25±2.81)、(14.75±4.31)、(13.86±1.95)d,差异均有统计学意义(P<0.05)。C组不良反应发生率与A组比较,差异无统计学意义(P>0.05)。C组、A组不良反应发生率分别为5.26%、3.70%,均低于B组的32.00%,差异均有统计学意义(P<0.05)。结论口服阿奇霉素联合支气管肺泡灌洗术治疗儿童RMPP临床疗效显著,可有效缩短患儿临床指标恢复正常时间,安全可行,与静脉滴注阿奇霉素联合支气管肺泡灌洗术比较,用药安全性提高,同样可促进患儿病情康复,值得推广应用。

Objective To discuss the clinical value of bronchoalveolar lavage combined with azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 90 children with RMPP were studied and divided into group A(27 patients),group B(25 patients)and group C(38 patients)according to different treatment methods.Group A was treated with oral azithromycin for suspension,group B was treated with intravenous azithromycin and bronchoalveolar lavage,and group C was treated with oral azithromycin for suspension and fiberoptic bronchoscopy.The clinical efficacy,recovery time of clinical indexes and the occurrence of adverse reactions were compared among the three groups.Results There was no statistically significant difference between group C and group B in the comparison of total effective rate of treatment(P>0.05).The total effective rate of treatment in group C and group B were 96.00%and 94.74%,which were higher than 59.26%in group A,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the recovery time of cough,chest X-ray,body temperature,and C-reactive protein in group C compared with group B(P>0.05).The recovery time of cough,chest X-ray,body temperature,and C-reactive protein were(11.29±2.49),(10.69±1.36),(11.26±3.13),and(10.17±1.29)d in group C,and(11.11±2.12),(10.65±1.39),(11.25±3.15),and(10.19±1.33)d in group B,which were shorter than(14.25±3.26),(13.25±2.81),(14.75±4.31),and(13.86±1.95)d in group A.The differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions in group C compared with group A(P>0.05).The incidence rates of adverse reactions in group C and group A were 5.26%and 3.70%,which were lower than 32.00%in group B,and the differences were statistically significant(P<0.05).Conclusion Oral azithromycin combined with bronchoalveolar lavage is clinically effective in the treatment of RMPP in children,and can effectively shorten the recovery time of clinical indicators.Compared with intravenous azithromycin combined with bronchoalveolar lavage,the medication safety is improved,and also can promote the recovery of children,which is worthy of promotion and application.