纤维支气管镜肺泡灌洗辅助治疗小儿重症支原体肺炎的临床效果研究

Study on clinical effect of bronchoalveolar lavage in children with severe mycoplasma pneumonia

目的探讨纤维支气管镜肺泡灌洗辅助治疗小儿重症支原体肺炎的临床效果。方法择取26例小儿重症支原体肺炎患儿为研究对象,随机分为对照组和实验组,每组13例。对照组给予常规治疗,实验组在对照组基础上给予纤维支气管镜肺泡灌洗辅助治疗。比较两组治疗前后实验室指标、免疫学指标水平及临床疗效、住院时间、退热时间、咳嗽缓解时间。结果实验组总有效率92.31%明显高于对照组的53.85%,差异有统计学意义(P<0.05)。实验组住院时间、退热时间、咳嗽缓解时间分别为(12.30±2.63)、(3.12±1.20)、(5.16±1.33)d,均明显短于对照组的(15.25±3.12)、(5.22±1.54)、(7.42±1.63)d,差异有统计学意义(P<0.05)。治疗后,两组白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均明显低于本组治疗前,且实验组WBC、PCT、IL-6、TNF-α水平分别为(7.63±1.52)×10^(9)/L、(88.36±25.13)ng/ml、(31.23±10.52)pg/ml、(45.63±10.52)fmol/ml,均明显低于对照组的(9.63±1.46)×10^(9)/L、(112.60±26.48)ng/ml、(45.20±12.30)pg/ml、(56.28±10.52)fmol/ml,差异有统计学意义(P<0.05)。治疗后,实验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(62.36±3.22)%、(35.44±2.52)%、(1.43±0.15),均明显高于对照组的(57.89±3.16)、(30.48±1.69)、(1.10±0.12),CD8^(+)(24.63±2.45)%明显低于对照组的(27.58±2.66)%,差异有统计学意义(P<0.05)。结论对重症支原体肺炎患儿给予纤维支气管镜肺泡灌洗辅助治疗,便于改善患儿临床症状,减轻炎性反应,提高免疫功能,值得临床采纳。

Objective To discuss the clinical effect of bronchoalveolar lavage in children with severe mycoplasma pneumonia.Methods A total of 26 children with severe mycoplasma pneumonia were studied,and were randomly divided into control group and experimental group,with 13 cases in each group.The control group was treated with conventional treatment,and the experimental group was treated with bronchoalveolar lavage on the basis of the control group.Both groups were compared in terms of the level of laboratory indicators and immunological indicators before and after treatment,clinical efficacy,the length of hospital stay,the time of fever remission,and the time of cough remission.Results The total effective rate of 92.31%in the experimental group was significantly higher than that of 53.85%in the control group,and the difference was statistically significant(P<0.05).The length of hospital stay,time of fever remission and time of cough remission of the experimental group were(12.30±2.63),(3.12±1.20)and(5.16±1.33)d,which were significantly shorter than those of(15.25±3.12),(5.22±1.54)and(7.42±1.63)d of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of white blood cell count(WBC),procalcitonin(PCT),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in both groups were significantly lower than those before treatment in this group;the levels of WBC,PCT,IL-6 and TNF-αin the experimental group were(7.63±1.52)×10^(9)/L,(88.36±25.13)ng/ml,(31.23±10.52)pg/ml and(45.63±10.52)fmol/ml,which were significantly lower than those of(9.63±1.46)×10^(9)/L,(112.60±26.48)ng/ml,(45.20±12.30)pg/ml and(56.28±10.52)fmol/ml in the control group;the differences were statistically significant(P<0.05).After treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the experimental group were(62.36±3.22)%,(35.44±2.52)%,(1.43±0.15),which were significantly higher than those of(57.89±3.16),(30.48±1.69),(1.10±0.12)in the control group;CD8^(+)of(24.63±2.45)%in the experimental group was significantly lower than that of(27.58±2.66)%in the control group;the differences were statistically significant(P<0.05).Conclusion Bronchoalveolar lavage for children with severe mycoplasma pneumonia can improve clinical symptoms,reduce inflammatory reaction and improve immune function,which is worthy of clinical adoption.