琥珀酸钠甲泼尼龙联合纤维支气管镜术治疗难治性肺炎支原体肺炎的疗效观察  

Therapeutic effects of sodium succinate methylprednisolone combined with fiexible bronchofiberscopy on refractory mycoplasma pneumoniae pneumonia

作　　者：咸阳 王铁岩[1] 郑纯凤[1] XIAN Yang WANG Tieyan ZHENG Chunfeng(Department of Pediatrics, The Second Hospital Affiliated to Qiqihar Medical College, Heiloagjiaag, Qiqihar 151000, China)

机构地区：[1]齐齐哈尔医学院附属第二医院儿科,黑龙江省齐齐哈尔市161000

出　　处：《河北医药》2016年第20期3072-3075,共4页Hebei Medical Journal

摘　　要：目的比较观察琥珀酸钠甲泼尼龙联合纤维支气管镜术治疗难治性肺炎支原体肺炎(RMPP)的临床疗效。方法选择120例RMPP患儿作为研究对象,随机分为激素组、支气管镜组和联合治疗组。常规治疗的基础上,激素组仅给予静脉注射琥珀酸钠甲泼尼龙进行治疗;支气管镜组仅给予纤维支气管镜术进行治疗;联合治疗组给予琥珀酸钠甲泼尼龙静脉注射联合使用纤维支气管镜术治疗。评价3组胸片恢复正常时间、咳嗽缓解时间、体温恢复时间、治疗前后超敏C-反应蛋白(CRP)恢复时间及不良反应。结果 3组患者各体温分布人数比较(F=9.929,P=0.042),组1和组3(χ2=9.043,P=0.011),组2和组3(χ2=8.402,P=0.015)差异有统计学意义;患儿在治疗2周后,体温恢复时间比较(F=7.024,P=0.013),组1与组3(t=7.505,P=0.010)、组2与组3(t=5.005,P=0.043)差异有统计学意义;患儿胸片恢复时间比较(F=6.559,P=0.028),组1与组3(t=6.384,P=0.022)、组2与组3(t=6.102,P=0.0.028),差异有统计学意义;患儿CRP恢复时间比较(F=8.066,P=0.007),组2与组3(t=6.432,P=0.030),差异有统计学意义;3组患儿治疗效果比较(F=20.557,P=0.000),组1和组3(χ2=14.607,P=0.001)、组2和组3(χ2=8.098,P=0.017)、组1和组2(χ2=6.857,P=0.032),差异统计学意义;患儿在血清铁蛋白比较(F=6.605,P=0.024),组1和组3比较(t=-5.509,P=0.040)、组2和组3比较(t=-7.159,P=0.015),差异均有统计学意义;在CRP的恢复程度差异有统计学意义(F=6.605,P=0.024),组1和组3比较(t=8.082,P=0.006)、组2和组3比较差异有统计学意义(t=8.892,P=0.004)。结论琥珀酸钠甲泼尼龙联合纤维支气管镜术治疗难治性肺炎支原体肺炎能更快地缓解临床症状,具有一定的临床疗效。Objective To observe the therapeutic effects of sodium succinate methylprednisolone combined with fiexible bronchofiberscopy on refractory mycoplasma pneumoniae pneumonia （ RMPP ） .Methods One hundred and twenty patients with RMPP who were admitted and treated in our hospital from January 2014 to October 2015 were randomly divided into hormone group （group 1）,bronchoscopy group （group 2） and combination treatment group （group 3）.The patients in hormone group,on the basis of conventional therapy, were given sodium succinate methylprednisolone by intravenous injection, the patients in bronchoscopy group were treated only by bronchoscopy, and the patients in combination treatment group were treated by sodium succinate methylprednisolone combined with fiexible bronchofiberscopy.After treatment,the time of recovery to normal status of chest radiograph,time of cough remission,time of body temperature recovery,the changes of ultra-sensitivity C-reactive protein （ CRP） and adverse reactions were observed and compared among the three groups.Results There were significant differences in the numbers of people with different body temperature among 3 groups, between group 1 and group group 3 and between group 2 and group 3 （ P 〈0.05 or P 〈0.01）.After 2-week treatment,there was a significant difference in the time of body temperature recovery between group 1 and group 3 and between group 2 and group 3 （ P 〈0.01 or P 〈0.05）.There was a significant difference in the time of recovery to normal status of chest radiograph between group 1 and group 3 and between group 2 and group 3 （ P 〈0.05）.There was a significant difference in the the recovery time of CRP between group 2 and group 3 （ P 〈0.05） .There were significant differences in the therapeutic effects, between group 1 and group group 3 and between group 2 and group 3 （ P 〈0.05 or P 〈0.01）.Moreover, after treatment, all the parameters mentioned above in the 3 groups were superior to those before treatment （ P 〈0.05 or

关 键 词：琥珀酸钠甲泼尼龙 纤维支气管镜术 支原体肺炎 

分 类 号：R563.13[医药卫生—呼吸系统]