经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗小儿重症肺炎的临床分析  

Clinical effect analysis of bronchoalveolar lavage combined with local administration of budesonide in the treatment of severe infantile pneumonia

作　　者：裴炜娜[1] 孙国栋 吴静 王海东[1] Pei Wei-na;Sun Guo-dong;Wu Jing;Wang Hai-dong(Pediatric Intensive Care Unit,The Second Hospital of Lanzhou University,Lanzhou 730030,China;Department of Infection Management and Public Health,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院,儿童重症医学科,甘肃兰州730030 [2]兰州大学第一医院,感染管理与公共卫生科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2021年第1期59-63,69,共6页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗小儿重症肺炎的疗效。方法以2017年5月—2020年6月兰州大学第二医院儿童重症监护室收治的195例行经纤维支气管镜肺泡灌洗的小儿重症肺炎患儿为研究对象,将患儿随机分为观察组(98例)和对照组(97例)。观察组在常规治疗基础上经纤维支气管镜给予0.9%氯化钠注射液灌洗联合布地奈德局部给药治疗;对照组在常规治疗基础上经纤维支气管镜给予0.9%氯化钠注射液灌洗治疗;比较患者治疗前1 d及治疗7 d后的氧合指数(PaO2/FiO2)、动脉血二氧化碳分压(PaCO2)、pH、乳酸、影像学改变及血白细胞分类计数、降钙素原、C-反应蛋白、白介素-6等相关指标。结果连续经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗后,患儿PaO2/FiO2高于治疗前,差异有统计学意义(P<0.05);PaCO2、pH、乳酸、降钙素原、C-反应蛋白、白介素-6均低于治疗前,差异有统计学意义(P<0.05)。结论经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗小儿重症肺炎能够显著改善临床指标,对于临床研究具有重要作用。Objective To explore the curative effect of bronchoalveolar lavage combined with local administration of budesonide in the treatment of severe infantile pneumonia.Methods 195 children with severe pneumonia treated in the Second Hospital of Lanzhou University from May 2017 to June 2020 were selected and divided into an observation group(98 cases)and control group(97 cases).The observation group was given bronchoalveolar lavage with 0.9%sodium chloride injection combined with budesonide local administration on the basis of conventional treatment;the control group was given lavage with 0.9%sodium chloride injection on the basis of conventional treatment.The curative effects in the two groups were observed.The partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen (PaO2/FiO2), partial pressureof carbon dioxide in arterial blood (PaCO2), pH, lactic acid, imaging changes, white blood cell count, procalcitionin,C-reactive protein, interleukin-6 and other related indicators were compared between 1 day beforeand 7 days after treatment. Results The PaO2/FiO2 of the children after continuous bronchoalveolar lavagecombined with local administration of budesonide were higher than those before treatment, and thedifferences were statistically significant (P<0.05);PaCO2, pH, lactic acid, imaging changes, procalcitionin,C-reactive protein, and interleukin-6 were all lower than those before treatment, and the differences werestatistically significant (P<0.05). Conclusion The bronchoalveolar lavage combined with local administrationof budesonide in the treatment of severe infantile pneumonia is feasible, which can significantly improvethe clinical indicators and play an important role in clinical research.

关 键 词：纤维支气管镜 支气管肺泡灌洗 小儿重症肺炎 布地奈德 

分 类 号：R720.597[医药卫生—急诊医学]