摘要
目的探讨支气管镜检查在早期识别重症肺炎支原体肺炎中的价值。方法选取2016年4月至2017年4月于安徽省儿童医院呼吸一科住院诊断为肺炎支原体肺炎的100例患儿,按重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)诊断标准,分为普通组(n=60)和重症组(n=40),分别行支气管镜检查,观察两组患儿支气管镜下表现,并行统计学分析。结果两组患儿支气管镜下黏膜均可见不同程度充血、肿胀及粘性分泌物产生,普通组炎性水肿导致管腔狭窄者4例(6.7%)、粘液或痰栓堵塞3例(5.0%)、气管黏膜纵行皱襞2例(3.3%)、黏膜表面结节样凸起1例(1.7%)、黏膜糜烂1例(1.7%),重症组则分别为12例(30.0%)、12例(30.0%)、2例(5.0%)、5例(12.5%)、5例(12.5%)。上述各气管镜表现,除纵行皱襞出现比例比较差异无统计学意义(P>0.05)外,其余各表现出现比例比较差异有统计学意义(P<0.05)。结论 SMPP患儿支气管镜下主要表现为炎性狭窄、粘液栓堵塞、黏膜表面结节样凸起及黏膜糜烂,为临床表现不典型SMPP的早期诊断提供依据。
Objective To investigate the value of bronchoscopy in early identification of severe mycoplasma pneumoniae pneumonia(SMPP).Methods From April 2016 to April 2017,100 children diagnosed as Mycoplasma pneumoniae pneumonia in the Department of Respiratory of Anhui Provincial Children s Hospital were selected according to the diagnostic criteria of SMPP.Bronchoscopy was performed in the general group(n=60)and the severe group(n=40).The bronchoscopy findings of the two groups were observed and statistical analysis was performed.Results The bronchoscopy mucosa of the two groups showed different degrees of congestion,swelling and viscous secretion.In the general group,there were 4 cases of inflammatory edema caused stenosis(6.7%),3 cases of mucus or sputum plug occlusion(5.0%),2 cases of tracheal mucosa(3.3%),1 case of mucosal surface nodular protrusion(1.7%),and 1 case of mucosal erosion(1.7%).In the severe group,there were 12 cases of inflammatory edema caused stenosis(30.0%),12 cases of mucus or sputum plug occlusion(30.0%),2 cases of tracheal mucosa(5.0%),5 cases of mucosal surface nodular protrusion(12.5%),and 5 case of mucosal erosion(12.5%).Except for the proportion of longitudinal creases(P>0.05),there was statistically significant between the two groups in the proportion of the inflammatory edema caused stenosis,mucus or sputum plug occlusion,tracheal mucosa,mucosal surface nodular protrusion and mucosal erosion(P<0.05).Conclusion The main manifestations of children with SMPP under bronchoscopy are inflammatory stenosis,mucus plug occlusion,mucosal nodular bulge and mucosal erosion,which provide a basis for the early diagnosis of atypical SMPP.
作者
张琪
许崇玉
毕良学
ZHANG Qi;XU Chong-yu;BI Liang-xue(Department of Respiratory,Anhui Provincial Children's Hospital,Hefei,Anhui 230000,China)
出处
《临床肺科杂志》
2019年第4期684-687,共4页
Journal of Clinical Pulmonary Medicine
关键词
支气管镜
重症
支原体肺炎
早期识别
bronchoscopy
severe
mycoplasmal pneumonia
early identification
