摘要
目的探讨纤维支气管镜检查及肺泡灌洗技术在儿童肺炎支原体肺炎(MPP)治疗中的临床应用价值。方法对2015年6月~2017年3月在我院儿内科住院的123例节段性肺炎支原体肺炎并肺不张的患儿进行纤维支气管镜检查及肺泡灌洗术,并设为灌洗组;选取同期在我院儿内科住院的、家属不同意行纤维支气管镜检查及肺泡灌洗的52例节段性MPP合并肺不张患儿为对照组。根据随机单双号将灌洗组患儿分为两组,单号采用温生理盐水(37℃,每次0.5 ml/kg)的62例患儿为生理盐水组,双号采用温生理盐水(37℃,每次0.5 ml/kg)+沐舒坦(每次1 mg/kg)的61例患儿为沐舒坦组,比较各组的发热时间、住院时间、住院费用、治疗总有效率等。结果灌洗组患儿纤维支气管镜检查均可见不同程度的黏膜充血及水肿,20.3%有黏膜滤泡增生,15.4%有痰栓,26.0%有黏膜肿胀充血继发性狭窄,4.1%有黏膜糜烂,2.4%有先天气道狭窄等。灌洗组病例发热时间为(5.6±1.4)d,住院时间为(13.3±1.7)d,医疗费用为(10 425.5±121.8)元;对照组发热时间为(8.3±1.7)d,住院时间为(15.7±1.5)d,医疗费用为(11 034.7±148.3)元,灌洗组均明显少于对照组(P<0.05)。灌洗组治疗有效率为98.4%,对照组为88.5%,灌洗组明显高于对照组(P<0.05)。沐舒坦组与生理盐水组发热时间[(5.5±1.6)d vs.(5.7±1.2)d]比较,差异无统计学意义(P>0.05)。沐舒组的住院时间为(12.9±1.5)d,住院费用为(10 122.5±125.7)元,生理盐水组住院时间为(13.9±1.8)d,住院费用为(10 725.3±109.5)元,沐舒坦组明显少于对照组(P<0.05);两组治疗总有效率均为98.4%。结论纤维支气管镜检查可以明确节段性MPP患儿气管黏膜损害情况,以便更好指导治疗;肺泡灌洗治疗可以缩短发热时间和住院时间,减少医疗费用,提高治疗效果;使用沐舒坦注射液为溶媒的灌洗可以进一步缩短住院时间和减少医疗费用。
Objective To explore the clinical application value of fiberbronchoscopy and bronchoalveolar lavage（BAL）in the treatment of Mycoplasma Pneumoniae pneumonia（MPP） children.Methods Totally 123 children with segmental MPP and pulmonary atelectasis,who was hospitalized and underwent fiberbronchoscopy and BAL in the Pediatrics Department of our hospital from June 2015 to March 2017 were selected as the BAL group;52 children with segmental MPP complicated with atelectasis and whose family members of children with different purposes of fiberoptic bronchoscopy or BAL in our hospital department during the same period were selected as the control group.According to the random number,the BAL group was divided into two groups：62 cases with the odd number and treated with warm saline（37℃,0.5 ml/kg per time） as the NS group;61 cases with even numbers and and treated with warm NS（37℃,0.5 ml/kg per time）＋Mucosolvan（1 mg/kg per time） as the Mucosolvan group.The fever time,hospital stay,hospital expenses,treatment total efficiency and so on of each group was compared.Results There was mucosal congestion and edema of different degrees were found by fiberbronchoscopy in all children of the BAL group,mucosalfollicular hyperplasia in 20.3% cases,phlegm embolus in 15.4% cases,mucosal swelling,congestion and secondary stenosis in 26.0% cases,mucosal erosion in4.1% cases,and congenital airway constriction in 2.4% cases.The fever time of BAL group was（5.6±1.4） d,hospitalization time was（13.3±1.7） d,medical expenses was（10 425.5±121.8） yuan,the control group fever time was（8.3±1.7） d,hospitalization time was（15.7±1.5） d,medical expenses was（11 034.7±148.3） yuan,and the BAL group was less than the control group（P〈0.05）;the effective rate of BAL group was 98.4%,the control group was 88.5%,so the BAL group was significantly higher than that of the control group（P〈0.05）.The fever time of Mucosolvan group was（5.5±1.6） d,NS group was（5.7±1.2） d,there were no significa
出处
《中国当代医药》
2017年第17期72-76,共5页
China Modern Medicine
基金
江西省九江市科技支撑计划项目(201601015)
关键词
纤维支气管镜
肺炎支原体
沐舒坦
肺炎
儿童
Fiberbronchoscopy
Mycoplasma Pneumoniae
Mucosolvan
Pneumonia
Children
