Lobar lung transplantation from deceased donors: A systematic review

AIM To systematically review reports on deceased-donor-lobar lung transplantation(dd LLTx) and uniformly describe sizematching using the donor-to-recipient predicted-total lung-capacity(pT LC) ratio. METHODS We set out to systematically review reports on ddL LTx and uniformly describe size matching using the donorto-recipient pT LC ratio and to summarize reported oneyear survival data of ddL LTx and conventional-LTx. We searched in Pub Med, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley(CDSR),Database of Abstracts of Reviews of Effects via Wiley(DARE), Cochrane Central Register of Controlled Trials via Wiley(CENTRAL), Scopus(which includes EMBASE abstracts), and Web of Science for original reports on ddL LTx. RESULTS Nine observational cohort studies reporting on 301 ddL LTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The dd LLTx-group was often characterized by high acuity;however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pT LC ratio was available for 242 ddL LTx(80%). The mean pT LCratio before lobar resection was1.25 ± 0.3 and the transplanted pT LCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddL LTxgroup ranged from 50%-100%, compared to 72%-88%in the conventional-LTx group. In the largest study ddL LTx(n = 138) was associated with a lower one-year-survival compared to conventional-LTx(n = 539)(65.1% vs84.1%, P < 0.001). CONCLUSION Further investigations of optimal donor-to-recipient size matching parameters for ddL LTx could improve outcomes of this important surgical option.

Acute lobar nephritis in children: Not so easy to recognize and manage

Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.

Analysis of effect of terbutaline sulfate combined with shunning on acute attack of asthma complicated with lobar pneumonia in children

Objective:To explore the effect of terbutaline sulfate combined with shunning on acute attack of asthma complicated with lobar pneumonia in children.Methods:One hundred and fifty children with acute attack of asthma and lobar pneumonia were randomly divided into routine group(seventy-five cases)and combined group(seventy-five cases).The routine group was given routine treatment.The study group was treated with routine therapy plus terbutaline sulfate plus shunning.The changes of pulmonary function and serum inflammatory factors before and after treatment,clinical effect and safety were compared between the two groups.Results:Respiratory time/inspiratory time(Ti/Te),peak time ratio(TPTEF/TE),peak volume ratio(VPEF/VE),tidal volume per kilogram(Vt/kg)were increased in both groups after treatment(P<0.05),which in the combined group were higher than the routine group after treatment(P<0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in both groups decreased significantly(P<0.05),and those in the combined group were lower than those in the routine group(P<0.05).There was a significant difference in clinical effect distribution between the two groups(P<0.05).The total effective rate of the combined group was higher than that of the routine group(P<0.05).The incidence of adverse reactions in the combined group was slightly higher than that in the routine group(P>0.05).Conclusion:On the basis of routine treatment,terbutaline sulfate combined with shunning can significantly improve pulmonary function and serum inflammatory factors in children with acute attack of asthma and lobar pneumonia,with ideal effect and safe.

Recurrent Lobar Torsion

We report a first case of 180° left upper lobe lung torsion followed by a 90° lobar torsion in the same lobe after a left lower lobectomy.

Congenital Lobar Emphysema in an Infant: A Case Report from the University Hospital of Mali

Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female infant, born at term without incident, was hospitalized for respiratory distress. On a postnatal day 15, respiratory distress occurred. On admission, he weighed 3400 g and was apyretic. He had a polypnea of 58 cycles/min and a oxygen saturation of hemoglobin of 90% on room air. A chest radiograph revealed hyperclarity of the left lung. Chest CT revealed left lower lobe emphysema. He underwent a left lower lobectomy. The postoperative course was uneventful. He was discharged from the hospital 7 days after surgery without sequelae. Physicians should be aware that congenital lobar emphysema can present with respiratory distress in infants. A chest CT scan confirms the diagnosis. Surgical treatment is effective.

Curative effect of small-dose glucocorticoids + azithromycin treatment of lobar pneumonia

Objective: To study the effect of small-dose glucocorticoids + azithromycin therapy on inflammatory response and stress response in children with lobar pneumonia. Methods:Children with mycoplasma pneumoniae lobar pneumonia who were treated in the First People's Hospital of Ziyang between January 2015 and January 2018 were chosen as the research subjects and randomly divided into two groups: GCs group were treated with low-dose glucocorticoids + azithromycin, and control group were treated with azithromycin. The inflammatory response indicators and stress response indicators in serum and peripheral blood were measured before treatment as well as 3 d and 5 d after treatment. Results: Compared with those of same group before treatment, peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of both groups were significantly decreased after treatment, and peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of GCs group after treatment were significantly lower than those of control group. Conclusion: Small-dose glucocorticoid +azithromycin therapy is more effective than azithromycin therapy to suppress the inflammatory and stress response in children with lobar pneumonia.

Histological and biochemical alterations in early-stage lobar ischemia-reperfusion in rat liver

AIM:To investigate the structural and biochemical changes in the early stage of reperfusion in the rat livers exposed to lobar ischemia-reperfusion (IR).METHODS: The median and left lobes of the liver were subjected to 60 min ischemia followed by 5, 10, 30, 45, 60 and 120 min reperfusion. Blood samples were taken at different time intervals to test enzyme activities and biochemical alterations induced by reperfusion. At the end of each reperfusion period, the animals were killed by euthanasia and tissue samples were taken for histological examination and immunohistochemistry. RESULTS: Cell vacuolation, bleb formation and focal hepatitis were the most important changes occur during ischemia. While some changes including bleb formation were removed during reperfusion, other alterations including portal hepatitis, inflammation and the induction of apoptosis were seen during this stage. The occurrence of apoptosis, as demonstrated by apoptotic cells and bodies, was the most important histological change during reperfusion. The severity of apoptosis was dependent on the time of reperfusion, and by increasing the time of reperfusion,the numbers of apoptotic bodies was significantly enhanced. The amounts of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatinine and urea were significantly increased in serum obtained from animals exposed to hepatic IR.CONCLUSION: Inflammation and subsequent apoptotic cell death were the most important changes in early-stage hepatic reperfusion injury, and the number of apoptotic bodies increased with time of reperfusion.

槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症因子及免疫功能的影响

目的:观察槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症反应及免疫功能的影响。方法:选取2020年1月~2022年12月某院收治的150例肺炎支原体感染致大叶性肺炎患儿为研究对象,采用随机数字表法分为对照组和观察组,每组75例。对照组在常规治疗基础上加用甲泼尼龙琥珀酸钠,观察组在对照组治疗基础上加用槐杞黄颗粒。比较两组患儿中医证候积分、炎症因子[高迁移率族蛋白B1(HMGB1)、降钙素原(PCT)、白细胞介素-17(IL-17)、IL-35]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、临床症状(发热、咳喘、肺部阴影)改善时间以及临床疗效。结果:治疗前,两组中医证候积分比较无统计学差异(P>0.05);治疗后,两组中医证候主症积分、次症积分和总积分均降低,且观察组各项积分均低于对照组(P<0.05)。治疗前,两组HMGB1、PCT、IL-17、IL-35等炎症因子水平比较均无统计学差异(P>0.05);治疗后,两组HMGB1、PCT、IL-17均降低,IL-35均升高(P<0.05),且观察组HMGB1、PCT、IL-17低于对照组,IL-35高于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较无统计学差异(P>0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,且观察组各指标高于对照组(P<0.05)。观察组退热、咳喘消失、肺部阴影消失时间均短于对照组(P<0.05),且临床治疗总有效率高于对照组(P<0.05)。结论:槐杞黄颗粒联合甲泼尼龙琥珀酸钠可有效减轻肺炎支原体感染致大叶性肺炎患儿的炎症反应,提高免疫功能,加快临床症状的改善和消失。

血清降钙素原联合超敏C反应蛋白对大叶性肺炎患儿预后的预测价值

目的:探讨降钙素原(PCT)联合超敏C反应蛋白(hs-CRP)对大叶性肺炎患儿预后的预测价值。方法:选择2019年1月—2022年1月于淮安市第二人民医院儿科病房住院的103例大叶性肺炎患儿为研究对象。检测所有患儿血清PCT、hs-CRP水平,根据患儿的预后情况分为治疗不佳组(n=10)与治愈组(n=93),收集患儿的临床资料,以多因素logistic回归分析大叶性肺炎的危险因素,制作受试者操作特征(ROC)曲线,以曲线下面积(AUC)评估血清PCT、hs-CRP对大叶性肺炎预后的预测价值。结果:两组患儿年龄、性别、身高、体重、白细胞计数对比,差异均无统计学意义(P>0.05);治疗不佳组hs-CRP、PCT水平均明显高于治愈组(P<0.05)。多因素logistic回归分析显示,血清PCT、hs-CRP均为大叶性肺炎治疗不佳的危险因素(P<0.05)。血清PCT、hs-CRP单一及联合预测大叶性肺炎治疗不佳的AUC分别为0.805、0.810、0.921,联合预测AUC高于单一预测(P<0.05)。结论:大叶性肺炎患儿血清PCT、hs-CRP水平明显升高,与大叶性肺炎治疗不佳密切相关,且两者在预测大叶性肺炎预后中具有重要价值,PCT、hs-CRP联合预测大叶性肺炎治疗不佳价值更高。

布地奈德联合乙酰半胱氨酸雾化对儿童大叶性肺炎临床效果的研究分析

目的探讨布地奈德联合乙酰半胱氨酸对儿童大叶性肺炎的治疗效果。方法选取2021年1月—2022年12月在丰县人民医院治疗的120例大叶性肺炎患儿为研究对象,根据掷硬币法分为研究组及对照组,各60例。研究组采用布地奈德联合乙酰半胱氨酸雾化治疗,对照组采用布地奈德雾化治疗。比较两组患儿肺功能、血清炎症因子、临床症状消失时间。结果治疗后,研究组患儿各项肺功能指标改善情况优于对照组,研究组患儿血清超敏C反应蛋白及降钙素原水平低于对照组,研究组患儿临床症状消失时间较对照组更短,差异有统计学意义(P均<0.05)。结论使用布地奈德联合乙酰半胱氨酸雾化治疗大叶性肺炎,能快速改善肺功能,疗效更佳。

肺宁排毒汤联合常规治疗对肺炎支原体大叶性肺炎患者的临床疗效

目的考察肺宁排毒汤联合常规治疗对肺炎支原体大叶性肺炎患者的临床疗效。方法90例患者随机分为对照组和观察组,每组45例,对照组给予常规治疗,观察组在对照组基础上加用肺宁排毒汤,疗程2周。检测临床疗效、中医证候评分、炎症指标(WBC、N、CRP、ESR、PCT)、炎性细胞因子(TNF-α、IL-6、IL-8)、凝血指标(PLT、TT、PT、APTT、Fib、D-D)、肺部影像学积分、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、炎症指标、炎性细胞因子、PLT、肺部影像学积分降低(P<0.05),以观察组更明显(P<0.05);观察组TT、PT、APTT延长(P<0.05),Fib、D-D降低(P<0.05),并比对照组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论肺宁排毒汤联合常规治疗可安全有效地缓解肺炎支原体大叶性肺炎患者临床症状,改善炎症反应和凝血功能。

呈大叶性肺炎改变的儿童肺炎支原体肺炎的影响因素及列线图预测模型构建与验证

目的 预测呈大叶性肺炎改变的儿童肺炎支原体肺炎的列线图模型构建及验证。方法 选取扬州大学附属医院2016年1月至2019年6月接收的170例MPP病儿为建模组。选取该院2019年7月至2021年12月接收的150例MPP病儿为验证组。根据是否表现为大叶性肺炎将建模组病儿分为呈大叶性肺炎组(n=70)和未呈大叶性肺炎组(n=100)。对建模组病儿采用logistic回归法筛选呈大叶性肺炎改变的儿童MPP的危险因素;采用R软件构建预测呈大叶性肺炎改变的儿童MPP的列线图模型,绘制校准曲线评估预测呈大叶性肺炎改变的儿童MPP列线图模型的一致性,绘制受试者操作特征(ROC)曲线验证列线图模型准确性。结果 logistic分析显示建模组中呈大叶性肺炎组年龄、热程、大环内酯类药使用时间、中性粒细胞百分比、C反应蛋白(CRP)水平、乳酸脱氢酶(LDH)水平、丙氨酸转氨酶(ALT)、红细胞沉降率(ESR)、D-二聚体高于未呈大叶性肺炎组(P<0.05),其中热程更高(10.10±2.72比6.36±1.91)、大环内酯类药使用时间更高(5.20±1.59比3.50±1.02)、CRP更高(35.46±9.73比13.92±4.06)、D-二聚体更高(0.69比0.44)。logistic分析显示,热程、大环内酯类药使用时间、CRP、D-二聚体是呈大叶性肺炎改变的儿童MPP的危险因素(P<0.05)。基于危险因素用R软件建立列线图模型,建模组ROC曲线下面积为0.94[95%CI:(0.90,0.98)],验证组ROC曲线下面积为0.95[95%CI:(0.92,0.98)];列线图模型的Hosmer-Lemeshow拟合优度检验显示,建模组χ^(2)=6.81,P=0.557;验证组χ^(2)=6.50,P=0.591。结论 构建的预测呈大叶性肺炎改变的儿童MPP的列线图模型具有较大临床价值,可指导个体化治疗。

电子支气管镜肺泡灌洗术治疗儿童大叶性肺炎的临床研究

目的 探讨电子支气管镜肺泡灌洗术治疗儿童大叶性肺炎的镜下表现及临床效果。方法 回顾性分析2017年1月至2022年6月在空军军医大学第二附属医院儿科住院诊治的100例儿童大叶性肺炎患儿的临床资料。根据患儿的临床表现、查体资料、实验室检查及影像学检查结果,对患儿行电子支气管镜检查及肺泡灌洗术,检测肺泡灌洗液中的肺炎支原体(MP),将MP阳性患儿分为MP肺炎组(74例),MP阴性患儿分为非MP肺炎组(26例);对MP阳性者及时加用敏感抗生素治疗,通过临床症状、实验室检查、灌洗前后胸部CT及预后等情况,比较并分析两组患儿肺炎的临床特点。结果 MP肺炎组患儿白细胞计数为(7.5±3.3)×10^(9)/L,明显低于非MP肺炎组的(11.4±7.2)×10^(9)/L,经比较差异有统计学意义(t=2.654,P<0.05)。在100例儿童大叶性肺炎患儿中,电子支气管镜下以支气管黏膜炎症为主要表现,其中管腔狭窄8例,黏膜充血44例,黏膜肥厚3例,脓性分泌物附着87例,脓栓堵塞管腔14例,其他表现7例;MP肺炎组的管腔狭窄、黏膜充血、黏膜肥厚、脓性分泌物附着、脓栓堵塞管腔的分布均高于非MP肺炎组,但差异均无统计学意义(P>0.05)。MP肺炎组的肝功谷草转氨酶、α-羟丁酸脱氢酶均高于非MP肺炎组,MP肺炎组累及右肺炎症、左肺炎症、双肺炎症及合并胸腔积液的检出率均高于非MP肺炎组,但差异均无统计学意义(P>0.05);MP肺炎组与非MP肺炎组消化系统受累、神经系统受累、肾功能损害的分布差异均无统计学意义(P>0.05)。肺泡灌洗液中细菌培养阳性率低,仅为9例(9.0%)。MP肺炎组肺泡灌洗液培养阳性7例(9.5%,7/74),非MP肺炎组肺泡灌洗液培养阳性2例(7.7%,2/26)。荧光定量聚合酶链式反应(FQ-PCR)法检测的MP阳性率(74例,74.0%)明显高于血清MP特异性抗体(MP-IgM)法检测的MP阳性率(2例,2.0%),经比较差异有统计学意义(χ^(2)=107.000,P<0.05)。MP肺炎组患儿的症状缓解时间、肺啰音消失时间、抗生素调整时间和住院时间均大于非MP肺炎组,但差异均无统计学意义(P>0.05)。结论 电子支气管镜肺泡灌洗术治疗儿童大叶性肺炎的临床疗效确切,对MP阳性者尽早应用敏感抗生素进行治疗有助于改善患儿的临床症状及预后,可积极指导临床用药,避免抗生素滥用,缩短住院时间。

重度大叶性肺炎支气管肺泡灌洗术的疗效及影响病程的危险因素分析

目的 研究重度大叶性肺炎应用支气管肺泡灌洗术的临床疗效,分析影响病程长短的高危因素。方法 回顾性收集2018年1月至2022年1月石河子大学第一附属医院儿科确诊的重度大叶性肺炎患儿的临床资料,根据是否行支气管肺泡灌洗术,利用倾向性评分匹配(propensityscore matching,PSM)法按1∶1匹配灌洗组与对照组,比较两组患儿的治疗效果;同时灌洗组患儿根据病程是否>2周,分为长病程组及短病程组,分析两组患儿病程长短差异的原因。结果 (1)治疗后灌洗组患儿咳嗽缓解时间、退热时间、肺部啰音消失时间、肺部影像学表现减轻时间、白细胞(white blood cell,WBC)计数、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocytesedimentationrate,ESR)、降钙素原(procalcitonin,PCT)水平均低于对照组,差异有统计学意义(P<0.05)。(2)在灌洗组中,长病程组患儿的CRP、乳酸脱氢酶(lactate dehydrogenase,LDH)、发热峰值显著升高;多肺叶感染、合并胸腔积液、多种病原体感染比例显著高于短病程组,差异有统计学意义(P<0.05)。(3)二分类Logistic及受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析显示LDH、CRP是灌洗组患儿病程>2周的独立危险因素,LDH、CRP预测重度大叶性肺炎患儿病程>2周的最佳临界值分别为333U/L、32.6mg/L。结论(1)支气管肺泡灌洗术可缩短大叶性肺炎患儿的治疗时间,加快炎症的恢复,明显提高疗效。(2)多重病原混合感染、并发胸腔积液、LDH≥333U/L、CRP≥32.6mg/L是大叶性肺炎患儿肺泡灌洗后病程>2周的独立危险因素,需警惕病程延长的可能。

Mucoepidermoid Carcinomas Presented as Lobar Pneumonia

Mucoepidermoid carcinomas （MECs） had always been recognized as salivary gland tumors mainly steming from parotid and submandibular salivary glands. Eater, studies showed that MECs can occur in bronchus, esophagus, lacrimal glands, pancreas, thymus, and thyroid gland. MECs in bronchus are usually centrally located and are proposed to originate from submucosal minor salivary-type glands in large airways.

First successful bilateral living-donor lobar lung transplantation in China

Lung transplantation has been performed internationally as an effective treatment for a variety of end-stage lung＇diseases. A great disparity between the supply of donor organs and the demand of potential recipients has resulted in longer waiting time and annual increases in deaths on the lung transplant waiting list. Living-donor lobar lung transplantation （LDLLT） has become an established strategy to deal with the shortage of cadaveric donors. Encouraged by Starnes et al and Date et al, we began to apply the operation to a critically ill patient with bronchopulmonary dysplasia （BPD） firstly at Shanghai Pulmonary Hospital in China.

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

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。

纤维支气管镜肺泡灌洗术在儿童大叶性肺炎治疗中的效果

目的探讨纤维支气管镜肺泡灌洗术在儿童大叶性肺炎治疗中的效果。方法选取2020年1月至2022年12月佛山复星禅诚医院有限公司儿内科收治的86例儿童大叶性肺炎患儿为研究对象,按照随机数字表法将其分为对照组(43例)与实验组(43例)。对照组采用常规治疗,实验组采用纤维支气管镜肺泡灌洗术治疗,比较两组临床效果。结果治疗后,实验组免疫球蛋白M、免疫球蛋白A、免疫球蛋白G水平低于对照组,炎症因子水平低于对照组,肺功能指标优于对照组(P<0.05);实验组咳嗽消失时间、退热时间、肺部啰音消失时间、住院时间均短于对照组(P<0.05)。结论纤维支气管镜肺泡灌洗术在儿童大叶性肺炎治疗中的效果显著,值得推广。

纤维支气管镜下肺泡灌洗对MP感染致大叶性肺炎患儿炎性因子水平及免疫功能的影响

目的:分析纤维支气管镜下肺泡灌洗对肺炎支原体(Mycoplasma pneumoniae,MP)感染致大叶性肺炎(Lobar pneumonia,LP)患儿的影响。方法:选取2021年4月~2023年4月本院收治的92例MP感染致LP患儿作为研究对象,随机分为对照组和研究组,各46例。对照组患者静脉滴注乳糖酸红霉素和阿奇霉素治疗,研究组在对照组基础上加用纤维支气管镜下肺泡灌洗治疗。分析比较两组的临床疗效、肺功能、病情严重程度、炎性因子以及免疫功能。结果:治疗后,研究组总有效率、用力肺活量(Forced vital capacity,FVC)、最高呼气流量(Peak expiratory flow,PEF)、CD3+、CD4+、CD4+/CD8+均明显高于对照组(P<0.05);研究组临床肺部感染评分(Clinicalpulmonary infectionscore,CPIS)、血清C反应蛋白(C-reactiveprotein,CRP)、降钙素原(Procalcitonin,PCT)、烟酰胺磷酸核糖转移酶(Nicotinamide phosphoribosyl transferase,NAMPT)水平均明显低于对照组(P<0.05)。结论:纤维支气管镜下肺泡灌洗治疗MP感染致LP患儿,能提高临床疗效,改善肺功能、免疫功能,减轻炎性反应。

阿奇霉素联合头孢唑肟与甲泼尼龙对支原体感染致大叶性肺炎患儿的疗效及安全性

目的探讨支原体感染致大叶肺炎患儿使用阿奇霉素联合头孢唑肟与甲泼尼龙治疗的临床疗效及安全性。方法选取2020年3月至2023年3月接受治疗的120例患儿,按随机数字表分为对照组和观察组,对照组给予阿奇霉素联合头孢唑肟治疗,观察组给予阿奇霉素联合头孢唑肟加用小剂量甲泼尼龙治疗,观察2组患儿临床症状消退时间、住院时间、血清C反应蛋白(CRP)、乳酸脱氢酶(LDH)水平、红细胞沉降率(ESR)、动脉血气指标、血常规指标、不良反应、临床疗效及安全性等情况。结果治疗后2组患儿咳嗽、高热、肺部啰音、肺部阴影消失时间及住院时间均有明显改善,且观察组改善效果均更佳(P<0.05);血清CRP、LDH水平及ESR指标水平均有明显改善,且观察组改善效果均更佳(P<0.05);动脉血氧分压、动脉二氧化碳分压、WBC、NEUT及MONO指标水平均明显改善,且观察组改善效果均更佳(P<0.05);呕吐、腹泻及静脉炎总发生率及临床疗效均明显改善,且观察组显著优于对照组(P<0.05)。结论阿奇霉素联合头孢唑肟加用小剂量甲泼尼龙治疗支原体感染致大叶肺炎,起效速度快,不良反应少,疗效显著,安全性高,有效促进机体康复。