摘要
目的分析影响大叶性肺炎患儿多次支气管镜下治疗的危险因素。方法回顾性分析2017年1月~2019年8月在西安市儿童医院呼吸二科住院治疗并行支气管镜下灌洗的122例大叶性肺炎患儿临床资料,将患儿分为单次组和多次组(≥2次),对二组患儿的相关影响因素进行比较分析,并采用Logistic回归分析得到影响大叶性肺炎患儿多次支气管镜下灌洗的危险因素。结果122例患儿中单次组67例,多次组55例。多次组患儿支气管镜前热程(≥10天)的比例明显高于单次组,差异有统计学意义(P<0.05)。胸腔积液、肺不张及白细胞总数升高的发生率上,多次组明显高于单次组(P<0.05)。多次组CRP≥10 mg/L的比例高于单次组,差异有统计学意义(P<0.05)。支气管镜下,多次组粘液栓形成率明显高于单次组,差异有统计学意义(P<0.05)。Logistic回归分析显示,镜前热程、胸腔积液、肺不张及CRP≥10 mg/L支气管镜下粘液栓形成为大叶性肺炎患儿需多次行支气管镜下灌洗治疗的独立危险因素。结论早期是否积极行支气管镜灌洗治疗、CRP≥10 mg/L、并发症的发生及支气管镜下粘液栓形成,是影响大叶性肺炎患儿镜下治疗次数的重要危险因素。
Objective To investigate the risk factors of single and multiple bronchoscopic lavage therapy in children with lobar pneumonia.Methods The clinical data of 122 lobar pneumonia children at Department II of Respiratory Disease,Xi′an Children′s Hospital from January 2017 to August 2019 were retrospectively.The patients were divided into the single group and the multiple group(≥2 times),and the correlative index were compared between the two groups.Logistic regression analysis was performed to analyze the risk factors of multiple bronchoscopic lavage therapy in lobar pneumonia patients.Results Among 122 children,67 cases were in the single group and 55 cases in the multiple group.Children undergoing multiple bronchoscopy having the fever duration≥10 days before the bronchoscopy were more in the multiple group than in the single group(P<0.05).At the same time,the occurrence rate of pleural effusion and pulmonary atelectasis of the multiple group were higher than those of the single group(P<0.05).In addition,the rate of the total of CRP≥10 mg/L was higher in the multiple group than in the single group(P<0.05).Under bronchoscopy,the occurrence of mucous plug was higher in the multiple group than in the single group(P<0.05).After adjusted by multiple regression analysis,it found five factors were independent risk factors for multiple bronchoscopic procedures,which were fever duration before bronchoscopy,pleural effusion,pulmonary atelectasis,and CRP≥10mg/L.Conclusion Whether or not to actively begin bronchoscopy in early stage,inflammatory reaction,occurrence of the complication and the mucous plug in bronchoscopy are important risk factors for multiple bronchoscopic procedures.
作者
张悦鸣
张雯
ZHANG Yue-ming;ZHANG Wen(Department II of Respiratory Disease Xi′an Children′s Hospital,Xi′an,Shaanxi 710043,China)
出处
《临床肺科杂志》
2021年第1期70-73,共4页
Journal of Clinical Pulmonary Medicine
