纤维支气管镜肺泡灌洗术联合阿奇霉素治疗大叶性肺炎患儿的效果

Effects of fiberoptic bronchoscopy alveolar lavage combined with Azithromycin in treatment of children with lobar pneumonia

目的:观察纤维支气管镜肺泡灌洗术联合阿奇霉素治疗大叶性肺炎患儿的效果。方法:回顾性分析2021年4月至2023年2月该院收治的76例大叶性肺炎患儿的临床资料,按照治疗方法不同将其分为观察组和对照组各38例。两组均予以常规治疗,在此基础上,对照组采用阿奇霉素治疗,观察组在对照组基础上联合纤维支气管镜肺泡灌洗术治疗。比较两组临床疗效,临床指标(肺部啰音消失时间、退热时间、咳嗽消失时间、住院时间)水平,治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、FEV_(1)/用力肺活量(FVC)]水平、炎性指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)]水平,以及不良反应发生率。结果:观察组治疗总有效率为94.74%(36/38),高于对照组的76.32%(29/38),差异有统计学意义(P<0.05);观察组住院时间、肺部啰音消失时间、退热时间、咳嗽消失时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组PEF、FEV_(1)、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组IL-6、CRP、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:纤维支气管镜肺泡灌洗术联合阿奇霉素治疗大叶性肺炎患儿可提高治疗总有效率和肺功能指标水平,改善临床指标水平,降低炎性指标水平,效果优于单纯阿奇霉素治疗。

Objective:To observe effects of fiberoptic bronchoscopy alveolar lavage combined with Azithromycin in treatment of children with lobar pneumonia.Methods:The clinical data of 76 children with lobar pneumonia admitted to this hospital from April 2021 to February 2023 were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,38 cases in each group.Both groups were given routine treatment.On this basis,the control group was treated with Azithromycin,while the observation group was treated with fiberoptic bronchoscopy alveolar lavage on the basis of that of the control group.The clinical efficacy,the clinical indicators(lung rale disappearance time,antipyretic time,cough disappearance time,hospitalization time)levels,the lung function indicators[forced expiratory volume in one second(FEV_(1)),peak expiratory flow(PEF),FEV_(1)/forced vital capacity(FVC)]levels,the inflammatory indicators[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor(TNF-α)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 94.74%(36/38),which was higher than 76.32%(29/38)of the control group,and the difference was statistically significant(P<0.05).The hospitalization time,the lung rale disappearance time,the antipyretic time and the cough disappearance time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of PEF,FEV_(1) and FEV_(1)/FVC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of IL-6,CRP and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Fiberoptic bronchoscopy alveolar lavage combined with Azithromycin in the treatment of the children with lobar pneumonia can improve the total effective rate of treatment and the levels of lung function indicators,improve the levels of clinical indicators,and reduce the levels of inflammatory indicators.Moreover,it is superior to single Azithromycin treatment.