三联雾化方案联合支气管镜灌洗在儿童肺炎支原体肺炎中的应用效果

Effect of Triple Nebulization Protocol Combined with Bronchoscopic Lavage in Mycoplasma Pneumoniae Pneumonia in Children

目的:探究三联雾化方案联合支气管镜灌洗在儿童肺炎支原体肺炎(MPP)中的应用效果。方法:选取2022年1月—2023年8月佛山市南海区妇幼保健院收治的92例MPP儿童为研究对象,根据随机数表法分为观察组(n=46)与对照组(n=46)。对照组给予支气管镜灌洗治疗,观察组在对照组基础上增加三联雾化方案(布地奈德、沙丁胺醇、异丙托溴铵)治疗。比较两组临床疗效、临床症状转归情况、住院时间、炎症因子水平、血气指标及不良反应发生情况。结果:观察组治疗后临床疗效总有效率为97.83%,对照组为84.78%,观察组临床疗效总有效率明显比对照组高,差异有统计学意义(P<0.05);观察组发热消退时间、咳嗽消失时间、肺部湿啰音消失时间、平均住院时间均比对照组短,差异有统计学意义(P<0.05);两组治疗后炎症因子白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平与治疗前相比均降低,且观察组治疗后IL-6、CRP、PCT水平均比对照组低,差异有统计学意义(P<0.05)。两组治疗后血气指标血氧饱和度(SpO2)、动脉血氧分压(PaO2)水平与治疗前相比均升高,二氧化碳分压(PaCO_(2))水平与治疗前相比均降低,且观察组治疗后SpO2、PaO2水平均比对照组高,PaCO_(2)水平比对照组低,差异有统计学意义(P<0.05);观察组治疗期间不良反应总发生率比对照组高,差异无统计学意义(P>0.05)。结论:布地奈德、沙丁胺醇与异丙托溴铵三联雾化联合支气管镜灌洗在儿童MPP治疗中临床效果显著,能有效缩短相关临床症状消失时间及住院时间,减轻炎症反应,改善血气指标,具有一定安全性。

Objective:To explore the application effect of triple nebulization combined with bronchoscopy lavage in children with Mycoplasma pneumoniae pneumonia.Method:92 children with Mycoplasma pneumoniae pneumonia admitted to Foshan City,Nanhai District Maternal and Child Health Care Hospital from January 2022 to August 2023 were selected as the study subjects.They were randomly divided into an observation group and a control group according to the random number table method,with 46 cases in each group.The control group was treated with bronchoscopy lavage,while the observation group was treated with a triple nebulization regimen(budesonide,salbutamol and ipratropium bromide)on the basis of the control group.The clinical efficacy,clinical symptom outcomes,length of hospital stay,levels of inflammatory factors,blood gas indicators and incidence of adverse reactions were compared between the two groups.Result:The total effective rate of clinical efficacy was 97.83%in the observation group after treatment,while it was 84.78%in the control group.The total effective rate of clinical efficacy in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The observation group had shorter fever resolution time,cough resolution time,lung moist rale resolution time,and average hospitalization time than the control group,and the differences were statistically significant(P<0.05).After treatment,the inflammatory factors such as interleukin-6(IL-6),C-reactive protein(CRP),and Procalcitonin(PCT)of the two groups,which were lower levels than before(P<0.05).The levels of IL-6,CRP and PCT in observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of SpO_(2)and PaO_(2)in both groups were higher than before,while the partial pressure of carbon dioxide(PaCO_(2))levels were reduced compared with those before treatment(P<0.05).Moreover,the SpO_(2)and PaO_(2)levels in the observation group were higher than those in the control group,while PaCO_(2)levels were lower than those in the control group,with statistical significance(P<0.05).The total incidence of adverse reactions in the observation group was higher than that in the control group during treatment,but the difference between the two groups was not statistically significant(P>0.05).Conclusion:The combination of budesonide,salbutamol,and ipratropium bromide triple nebulization combined with bronchoscopy lavage has a significant clinical effect in the treatment of Mycoplasma pneumoniae pneumonia in children.It can effectively shorten the time for relevant clinical symptoms to disappear and hospitalization,reduce inflammatory reactions,improve blood gas indicators,and has certain safety,which is worth promoting.