纤维支气管镜肺泡灌洗联合糖皮质激素对小儿重症肺炎的影响研究

Effect of fiberoptic bronchoalveolar lavage combined with glucocorticoid on severe pneumonia in children

目的 探讨纤维支气管镜肺泡灌洗联合糖皮质激素对小儿重症肺炎的影响。方法 以永州市中心医院2019年7月—2022年12月92例重症肺炎患儿为研究对象,随机分为对照组46例(给予常规联合糖皮质激素治疗)和观察组46例(在对照组基础上另给予纤维支气管镜肺泡灌洗);对比两组临床症状、炎性指标、血气指标及预后。结果 观察组患儿退热时间、肺部啰音持续时间、咳嗽时间明显短于对照组,影像好转率明显高于对照组(P<0.05)。治疗后7 d、治疗后2周观察组患儿降钙素(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)水平明显低于对照组,差异具有统计学意义(P<0.05)。治疗后7 d、治疗后2周观察组患儿PaCO_(2)水平明显低于对照组,PaO_(2)、SaO_(2)水平明显高于对照组(P<0.05)。观察组30 d病死率(4.35%)与对照组(6.52%)无明显差异(P>0.05);观察组治疗有效率(93.48%)明显高于对照组(69.57%)(P<0.05)。结论 纤维支气管镜肺泡灌洗联合糖皮质激素能够更快速改善小儿重症肺炎临床症状、血气分析参数,降低患儿炎性指标,并提高患儿治疗有效率。

Objective Exploring the effect of fiberoptic bronchoscopic alveolar combined with glucocorticoids on severe pneumonia in children.Methods Selecting 92 children with severe pneumonia in Yongzhou Central Hospital from July 2019 to December 2022 as the research objects,they were randomly divided into the control group of 46 cases,who were given routine combined with glucocorticoids treatment;the observation group of 46 cases,in addition to the control group,fiberoptic bronchoscopic alveolar lavage was also given;the clinical symptoms,inflammatory indexes,blood gas indexes and prognosis of the two groups were compared.Results The children in the observation group had a significantly shorter time for fever reduction,duration of lung rales,and coughing time than that of the control group,and the rate of improvement in imaging was significantly higher than that of the control group(P<0.05).Procalcitonin(PCT),C-reactive protein(CRP)and white blood cell count(WBC)levels in the observation group were significantly lower than those in the control group 7 days and 2 weeks after treatment,and the difference was statistically significant(P<0.05).The PaCO_(2) level of the children in the observation group was significantly lower than that of the control group at 7 days and 2 weeks after treatment,and the PaO_(2) and SaO_(2) levels were significantly higher than those of the control group(P<0.05).There was no significant difference between the 30 days morbidity and mortality rate of the observation group(4.35%)and that of the control group(6.52%)(P>0.05);the effective rate of treatment of the observation group(93.48%)was significantly higher than that of the control group(69.57%)(P<0.05).Conclusion Fiberoptic bronchoalveolar lavage combined with glucocorticoids can rapidly improve the clinical symptoms,blood gas analysis parameters,reduce inflammatory indexes of severe pneumonia in children,and improve the treatment efficiency.