支气管肺泡灌洗术在儿童重症支原体肺炎早期干预中的临床研究

Clinical study of bronchoalveolar lavage in early intervention of severe mycoplasma pneumonia in children

目的:探讨支气管肺泡灌洗术在儿童重症支原体肺炎(SMPP)早期干预中的临床效果。方法:选取医院2021年6月—2023年3月收治的94例SMPP患儿,依据其法定监护人是否接受支气管肺泡灌洗术治疗进行分组,同意行支气管肺泡灌洗术治疗的患儿纳入治疗组(n=45),不同意则纳入对照组(n=49)。两组患儿均给予阿奇霉素、雾化、祛痰等治疗,治疗组患儿在此基础上接受支气管肺泡灌洗术治疗,出院后随访2个月。比较两组患儿入院后体温恢复正常时间、咳嗽消失时间及住院时间,比较两组患儿治疗前、治疗1周、出院后2个月炎症因子变化情况,同时比较两组患儿治疗1周时肺部阴影吸收面积,观察两组治疗期间不良反应发生情况。结果:治疗组患儿入院后体温恢复正常时间、咳嗽消失时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。两组治疗前血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-8(IL-8)比较,差异无统计学意义(P>0.05);治疗1周后,两组血清CRP、TNF-α、IL-6和IL-8较治疗前均下降,且治疗组均低于对照组,差异有统计学意义(P<0.05);出院后2个月,两组患儿CRP、TNF-α、IL-6和IL-8水平均降低,但两组组间比较差异无统计学意义(P>0.05)。治疗1周时,两组患儿肺部阴影吸收面积比较,治疗组大于对照组,差异有统计学意义(P<0.05)。两组患儿治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在儿童SMPP早期干预中应用支气管肺泡灌洗术可有效缓解患儿临床症状,缩短病程,并能够加速炎症反应缓解,促进肺部阴影的吸收,且安全性良好。

To explore the clinical effects of bronchoalveolar lavage as an early intervention for severe mycoplasma pneumonia(SMPP)in children.Methods:94 children with SMPP admitted to the hospital between June 2021 and March 2023 were selected and divided into groups based on whether their legal guardians had received bronchoalveolar lavage treatment.Children who agreed to undergo bronchoalveolar lavage were included in the treatment group(n=45),and those who disagreed were included in the control group(n=49).Both groups of children were treated with azithromycin,nebulization,and expectorant therapy.The treatment group underwent bronchoalveolar lavage on this basisand was followed up for two months after discharge.Body temperature recovery time,cough disappearance time,and hospitalization time after admission were compared between the two groups.Changes in inflammatory factors before treatment,one week after treatment,and two months after discharge were compared between the two groups.At the same time,the absorption area of the lung shadow one week after treatment was compared between the two groups.The incidence of adverse reactions during treatment was observed in both groups.Results:The temperature recovery time,cough disappearance time,and hospitalization time were significantly shorter in the treatment group than in the control group(P<0.05).There were no statistically significant differences in serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8)levels between the two groups before treatment(P>0.05).After one week of treatment,the serum levels of CRP,TNF-α,IL-6,and IL-8 in both groups decreased compared to those before treatment,and the treatment group was significantly lower than the control group(P<0.05).Two months after discharge,the average levels of CRP,TNF-α,IL-6,and IL-8 in both groups decreased,but there was no statistically significant difference between the two groups(P>0.05).At one week of treatment,the lung shadow absorption area of the treatment group was significantly larger than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of children during treatment(P>0.05).Conclusions:The application of bronchoalveolar lavage in early intervention of SMPP in children can effectively alleviate clinical symptoms,shorten the course of the disease,accelerate the relief of the inflammatory response,promote the absorption of lung shadows,and have good safety.