支气管肺泡灌洗术对儿童重症肺炎的临床疗效分析
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摘要
目的:为采用支气管肺泡灌洗术治疗儿童重症肺炎提供基础研究参考资料。方法:选取2014年9月至2017年9月在我院就诊的重症肺炎患儿67例,根据治疗方法不同分为研究组(采用常规治疗方法+支气管肺泡灌洗术)34例和对照组(采用常规治疗方法)33例,检测患儿血清白细胞、C反应蛋白和降钙素水平,评价治疗效果并比较两组患儿的预后及并发症发生情况。结果:研究组患儿治愈率和总有效率分别为52.94%和91.18%,均高于对照组的24.24%和66.67%(P均<0.05);住院时间、咳嗽消失时间、抗生素使用时间、啰音消失时间、胸部X线片阴影消退时间、发热时间均短于对照组(P均<0.05)。治疗后两组患儿血清白细胞、C反应蛋白和降钙素水平均较治疗前下降,且研究组均低于对照组(P均<0.05)。两组患儿发生发热、一过性低氧血症、咳嗽加重的比例比较差异均无统计学意义(P均>0.05),但研究组患儿发生呼吸急促的比例低于对照组(P<0.05)。结论:支气管肺泡灌洗术对儿童重症肺炎具有良好的治疗效果,且并发症较少。
Objective: To provide basic research references for bronchoalveolar lavage for severe pneumonia in children. Methods:Sixty-seven children with severe pneumonia admitted into Sept. 2014 to Sept. 2017 were extracted to be divided into research group( conventional treatment + bronchoalveolar lavage) with 34 cases and control group( conventional treatment) with 33 cases. Serum leukocytes,C-reactive protein and calcitonin levels were detected,therapeutic effects were evaluated,prognosis and complications of two groups were compared. Results: The cure rate and total efficiency of research group were 52. 94% and 91. 18% respectively,higher than those of control group 24. 24% and 66. 67%( P < 0. 05). The length of stay,disappearance time of cough,application time of antibiotics,disappearance time of rales,disappearance time of chest X-ray shadow and time of fever of research group were all shorter than those of control group( P< 0. 05). After treatment,the serum leukocytes,C-reactive protein and calcitonin levels of both groups were decreased compared with before treatment,and the research group was lower than the control group( P < 0. 05). There was no statistically significant difference in the incidence of fever,transient hypoxemia,and worsening of cough in two groups( P>0. 05),yet the rate of tachypnea in research group was lower than that in control group( P < 0. 05). Conclusion: Bronchoalveolar lavage has significant therapeutic effects in children with severe pneumonia with fewer complications.
Objective: To provide basic research references for bronchoalveolar lavage for severe pneumonia in children. Methods:Sixty-seven children with severe pneumonia admitted into Sept. 2014 to Sept. 2017 were extracted to be divided into research group( conventional treatment + bronchoalveolar lavage) with 34 cases and control group( conventional treatment) with 33 cases. Serum leukocytes,C-reactive protein and calcitonin levels were detected,therapeutic effects were evaluated,prognosis and complications of two groups were compared. Results: The cure rate and total efficiency of research group were 52. 94% and 91. 18% respectively,higher than those of control group 24. 24% and 66. 67%( P < 0. 05). The length of stay,disappearance time of cough,application time of antibiotics,disappearance time of rales,disappearance time of chest X-ray shadow and time of fever of research group were all shorter than those of control group( P< 0. 05). After treatment,the serum leukocytes,C-reactive protein and calcitonin levels of both groups were decreased compared with before treatment,and the research group was lower than the control group( P < 0. 05). There was no statistically significant difference in the incidence of fever,transient hypoxemia,and worsening of cough in two groups( P>0. 05),yet the rate of tachypnea in research group was lower than that in control group( P < 0. 05). Conclusion: Bronchoalveolar lavage has significant therapeutic effects in children with severe pneumonia with fewer complications.
引文
[1]黄光举,张慧玉,田玲,等.支气管镜检查及肺泡灌洗术治疗儿童重症肺炎的临床研究[J].中外医疗,2015,14(10):30-31.
[2]孙军锋,王伟,安淑华,等.纤维支气管镜灌洗术对支原体肺炎患儿的影响[J].中国临床医生,2013(7):14-15.
[3]董改琴,吕翔,陈敏华.支气管镜肺泡灌洗术治疗儿童难治性肺炎的临床分析[J].皖南医学院学报,2016,35(1):72-74.
[4]黄艳,崔振泽.支气管肺泡灌洗在儿童呼吸系统疾病中的作用[J].中国小儿急救医学,2013,20(1):20-24.
[5]苏宇飞,常文毅,王列,等.纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的疗效探讨[J].中国妇幼健康研究,2016,27(1):58-61.
[6]刘清彪,罗慧嫦,许柏华,等.纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的效果观察[J].中国当代医药,2017,24(25):107-109.
[7]中华医学会儿科分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[8]肖志兵,范楚平,刘婵,等.儿童重症社区获得性肺炎支气管肺泡灌洗液病毒病原学分析[J].医学理论与实践,2016,29(14):1936-1938.
[9]马力忠,莫庆仪,梁桂明,等.支气管肺泡灌洗术在小儿重症肺炎支原体肺炎患者抢救中的临床应用价值[J].中国现代医生,2015,53(5):44-49.
[10]邱敏珊,尹海燕.支气管肺泡灌洗术对卒中并发重症肺炎患者的作用[J].中国脑血管病杂志,2016,13(11):569-574.
[11]占明.纤维支气管镜联合肺泡灌洗术治疗呼吸机相关性肺炎患者的临床疗效分析[J].中华肺部疾病杂志(电子版),2014,7(4):8-11.
[12]关国宏,黄健增,马永亮.经纤维支气管镜吸痰联合肺泡灌洗术治疗重症肺炎的应用分析[J].当代医学,2014,20(11):21-23.
[13]臧金萍.支气管肺泡灌洗术在重症肺炎有创机械通气辅助治疗中应用分析[J].医药论坛杂志,2016,37(4):99-100.
[14]甄清,张冲林,苏建忠,等.纤支镜及支气管肺泡灌洗术在儿童迁延性肺炎的临床应用[J].临床肺科杂志,2015,20(10):1904-1906.
[15]陆燕红,郝创利.支气管镜肺泡灌洗治疗儿童支原体肺炎的临床分析[J].实用医学杂志,2011,27(2):348-349.
[16]许柏华,胡婷,钟亮,等.纤维支气管镜及支气管肺泡灌洗术在儿童迁延性肺炎诊治过程中的应用[J].现代诊断与治疗,2016,27(19):3636-3637.
[17]王娟,孙军,高长龙,等.纤维支气管镜肺泡灌洗术治疗儿童难治性支原体肺炎疗效分析[J].临床儿科杂志,2017,35(1):16-18.
[18]刘东海,周丽.支气管肺泡灌洗在小儿肺部疾病中的应用进展[J].中国妇幼健康研究,2012,23(5):688-690.
[19]陈强.纤维支气管镜肺泡灌洗术治疗儿童大叶性肺炎的效果观察[J].中国当代医药,2017,24(8):110-112.
[2]孙军锋,王伟,安淑华,等.纤维支气管镜灌洗术对支原体肺炎患儿的影响[J].中国临床医生,2013(7):14-15.
[3]董改琴,吕翔,陈敏华.支气管镜肺泡灌洗术治疗儿童难治性肺炎的临床分析[J].皖南医学院学报,2016,35(1):72-74.
[4]黄艳,崔振泽.支气管肺泡灌洗在儿童呼吸系统疾病中的作用[J].中国小儿急救医学,2013,20(1):20-24.
[5]苏宇飞,常文毅,王列,等.纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的疗效探讨[J].中国妇幼健康研究,2016,27(1):58-61.
[6]刘清彪,罗慧嫦,许柏华,等.纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的效果观察[J].中国当代医药,2017,24(25):107-109.
[7]中华医学会儿科分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[8]肖志兵,范楚平,刘婵,等.儿童重症社区获得性肺炎支气管肺泡灌洗液病毒病原学分析[J].医学理论与实践,2016,29(14):1936-1938.
[9]马力忠,莫庆仪,梁桂明,等.支气管肺泡灌洗术在小儿重症肺炎支原体肺炎患者抢救中的临床应用价值[J].中国现代医生,2015,53(5):44-49.
[10]邱敏珊,尹海燕.支气管肺泡灌洗术对卒中并发重症肺炎患者的作用[J].中国脑血管病杂志,2016,13(11):569-574.
[11]占明.纤维支气管镜联合肺泡灌洗术治疗呼吸机相关性肺炎患者的临床疗效分析[J].中华肺部疾病杂志(电子版),2014,7(4):8-11.
[12]关国宏,黄健增,马永亮.经纤维支气管镜吸痰联合肺泡灌洗术治疗重症肺炎的应用分析[J].当代医学,2014,20(11):21-23.
[13]臧金萍.支气管肺泡灌洗术在重症肺炎有创机械通气辅助治疗中应用分析[J].医药论坛杂志,2016,37(4):99-100.
[14]甄清,张冲林,苏建忠,等.纤支镜及支气管肺泡灌洗术在儿童迁延性肺炎的临床应用[J].临床肺科杂志,2015,20(10):1904-1906.
[15]陆燕红,郝创利.支气管镜肺泡灌洗治疗儿童支原体肺炎的临床分析[J].实用医学杂志,2011,27(2):348-349.
[16]许柏华,胡婷,钟亮,等.纤维支气管镜及支气管肺泡灌洗术在儿童迁延性肺炎诊治过程中的应用[J].现代诊断与治疗,2016,27(19):3636-3637.
[17]王娟,孙军,高长龙,等.纤维支气管镜肺泡灌洗术治疗儿童难治性支原体肺炎疗效分析[J].临床儿科杂志,2017,35(1):16-18.
[18]刘东海,周丽.支气管肺泡灌洗在小儿肺部疾病中的应用进展[J].中国妇幼健康研究,2012,23(5):688-690.
[19]陈强.纤维支气管镜肺泡灌洗术治疗儿童大叶性肺炎的效果观察[J].中国当代医药,2017,24(8):110-112.